267700018-9-10-2025-12-CC-JDMO-DLDQ3W-20250910114925

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 267700018
Report Date: 09/10/2025
Date Signed: 09/10/2025 11:50:14 AM

Document Has Been Signed on 09/10/2025 11:50 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	ROSAS FAMILY CHILD CARE		FACILITY NUMBER:	267700018
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	09/10/2025
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:10 AM
MET WITH:	Maria Rosas, Applicant		TIME VISIT/ INSPECTION COMPLETED:	11:47 AM

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On September 10, 2025, at 8:10 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted a Pre-Licensing inspection with applicant, Maria Rosas, to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. The licensee relocated and is requesting to provide care for a small family childcare home for the capacity of 8 children at this new location. Currently living in the home are the applicant, applicant’s spouse, and two minor children. The applicant’s spouse and the LPA toured the home indoor and out to ensure it meets FCCH requirements. The applicant is requesting to provide care for children ages zero to six years of age. The applicant is requesting the days and hours of operation will be Monday to Friday, from 8:00 A.M. to 5:00 P.M. At 9:21 A.M., there was one child that was dropped off at the home. The applicant was supervising the child during this visit.

The home is described as follows:

This is a one-story mobile home with three bedrooms, three bathrooms, living room (main care), kitchen, dining area, , and a parking area. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose danger to children. Off-limits areas: bedrooms #1, #2, and #3, bathroom #2, laundry room, and kitchen, On limits: living room, dining area, and bathroom #1.

Indoor:

On limits:

Living room (Main care): LPA observed couches, television, drawer, diaper changing table, different kinds

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

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of toys, and a fireplace. The fireplace is blocked by an iron gate. The outlets are covered. However, LPA observed the window has a missing glass window.
Dining area (Adjacent to the living room and kitchen): LPA observed dining table, chairs, lamp stand, and a highchair. The outlets are covered.
Bathroom #1 (Located between bedroom 3 and laundry room): LPA observed toilet, shower, faucet, and sink and are in operable condition. LPA did not observe razors and/or sharp objects, shampoos, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care. LPA also observed paper towels, tissue paper, and a trash bin. The outlets are covered.
Electrical outlets: Outlets in on-limit areas have child safety plastic plugs.

Off-limit area

Bedroom # 1 (Adjacent to one of the closet and bedroom #2): Bedroom #1 was equipped with a king-size bed, electric fan, lamp stand, and a closet which contains personal items. LPA observed razors and mouthwash on the bed. The applicant was advised to keep the razors and mouthwash inaccessible to children. The applicant spouse told the LPA that they will keep the razors and mouthwash inside the drawers. Bedroom #1 does not have a child safety doorknob cover.
Bedroom # 2 (Located between bedroom #1 and bathroom #2): Bedroom #2 was equipped with a full-sized bed, 2 dressers, electric fan, closet, and other personal furnishings. Bedroom #1 does not have a child safety doorknob cover.
Bedroom # 3 (Adjacent to bathroom #1 and bathroom #2): Bedroom #3 was equipped with a king-size bed, 2 nightstands, a dresser, television, and a closet that contains personal items. Bedroom #2 does not have a child safety doorknob cover.
Bathroom #2: LPA observed toilet, shower, faucet, and sink and are in operable condition. The bathroom has a medicine cabinet where household medications are stored.
Kitchen (Located adjacent to laundry room and living room): LPA observed stove, refrigerator, dishwasher, microwave oven, and a coffee pot. The outlets in the kitchen have child safety covers. The knives are stored inside the upper kitchen cabinets with child safety latch. Cleaning compounds are stored under the kitchen sink cabinet with child safety latch. The kitchen does not have a child safety baby gate. LPA also observed the kitchen stove knobs do not have child safety covers. Per applicant’s spouse, they will

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

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install child safety baby gate in the kitchen. Per applicant, meals and snacks will not be provided to children in care. LPA told the applicant that if food was brought from children’s home, the container shall be labeled with the child’s name and the food be properly stored or refrigerated.
Laundry room: The laundry room contains a washer and dryer. LPA observed other cleaning compounds are stored on the lower and upper cabinets of the laundry room. LPA also observed floor mops inside the laundry room. The laundry room has an exit door leading outside. The laundry room does not have a child safety doorknob cover.
The home does not have a backyard, and LPA did not observe body of water on the premises.
Napping equipment: LPA observed observe 5 sleeping cots, 1 foldable crib, and 2 bed mattresses.
Weapons or Firearms: Per applicant, there are zero firearms or weapons. LPA did not observe any weapons or firearms.
Knives: Stored inside the upper kitchen cabinet with child safety latch.
Poisons, Detergents and Cleaning compounds: Cleaning compounds were observed in the upper and lower cabinets of the laundry room and under the kitchen sink.
A smoke detector and a carbon monoxide detector: Tested at 9:40 A.M. Carbon monoxide detector and smoke detector are in operable condition.
Fire extinguisher (2-A:10-B:C): There is a 3-A:40-B:C type of fire extinguisher.
First Aid Kit: LPA observe the first aid kit stored on the upper shelf next to the fireplace. The applicant has a non-contact thermometer.
Pets: LPA observed did not observe pets inside the home.
Medications: Stored inside bathroom #2 and in the upper kitchen cabinets with child safety latch.
Documentation:
Applicant completed the Prevented Health and Safety Training with the nutrition and lead component on June 3, 2023, Applicant completed the pediatric First Aid and CPR Training on August 19, 2025, and mandated reporter training on August 21, 2025. The applicant has required immunizations, Pertussis and Measles. Per applicant’s spouse, the applicant took the Influenza vaccine on March of this year. The applicant has TB Risk Assessment on file.

The applicant’s spouse has proof of control of property which is the Residential Lease Agreement with a

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

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stipulation date of March 1, 2025. The applicant’s spouse is the person who signed the Agreement. The applicant's spouse was provided with a copy of the declaration form stating that the applicant spouse is allowing the applicant to use the home in conducting day care services.

Per Applicant, transportation will not be provided.

The following was discussed with the applicant:

1. The following items are zero tolerance by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.

2 Pediatric First Aid and CPR: American Heart Association or American Red Cross or Emergency Medical Services Authority (EMSA) approved in Pediatric First Aid and CPR must be present. Certification must be renewed every two years.

3. Applicant was informed that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

4. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

5. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

6. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

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7. The fire extinguisher type 2-A:10-B:C must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

9. Smoking is prohibited in the family childcare home.

10. Children and staff records must be maintained and updated as needed and be available for review by the Department.

11. Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles.

12. Inspection Authority: All adults living and working in the home shall be made aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

13. The facility license number must be on all advertisements, publications, or announcements with the intent of attracting clients.

14. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home). Part of the dining area will serve as an isolation area.

15. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information. Licensee is planning to have liability insurance.

16. Dog(s) and/or pets are recommended to be isolated from children in care.

17. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

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18. The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility provides care per day.

Mandatory licensing forms such as LIC 311D Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; The applicant was reminded that 100% supervision is required at all times to children in care; Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care.

The applicant was made aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and to the Department on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. The applicant was informed to utilize the Unusual Incident Report/Injury Report form (LIC624B) when sending the report to the department. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Applicant was informed that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

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initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage: atttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with the Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met, civil penalties per violation will be assessed.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from the date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Building an in-ground or above-ground swimming pool, conversion of a garage (either attached or detached) into a "childcare" room;

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

NARRATIVE

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Room additions to the family childcare home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition, or construction.

Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

The applicant was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send them by email to: inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the CCLD website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA checked Megan’s Law website and confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

During this visit, the applicant's spouse install the missing glass window in the living room (main care) of the facility.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

Page: 8 of 10

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 267700018
	VISIT DATE: 09/10/2025

NARRATIVE

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As a result of this inspection, the home does not meet Title 22 Regulations. Final approval is pending the following:

1. Physical Plant – 102417(g): The applicant will install child safety covers for the doorknobs in the off-limits bedrooms and laundry room. The applicant will install child safety baby gate in the kitchen. The applicant will provide a copy of her Influenza vaccine.

The applicant will send photos of the corrections on September 15, 2025.

An exit interview was conducted, and a copy of this report and appeal rights were discussed with the Applicant, Maria Rosas and applicant’s spouse, Victor Flores.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2025

LIC809 (FAS) - (06/04)

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