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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 267750002
Report Date: 08/18/2026
Date Signed: 08/18/2026 04:49:40 PM

Document Has Been Signed on 08/18/2026 04:49 PM - 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:MAMMOTH INCLUSIVE PRESCHOOLFACILITY NUMBER:
267750002
ADMINISTRATOR/
DIRECTOR:		TAMMY NGUYENFACILITY TYPE:
850
ADDRESS:1500 MERIDIAN BLVD.TELEPHONE:
(760) 934-7545
CITY:MAMMOTH LAKESSTATE: CAZIP CODE:
93546
CAPACITY: 15TOTAL ENROLLED CHILDREN: 7CENSUS: 0DATE:
08/18/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Jackie Ramirez, Lead TeacherTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On August 18, 2025, at 1:10 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with the Lead Teacher, Jackie Ramirez, to conduct an unannounced annual inspection for the Preschool license in accordance with the facility sketch. The preschool component is located on the grounds of Mammoth Elementary School in building J/Classroom #3. A tour of the facility was conducted. LPA did not observe children inside the classroom. The Lead Teacher stated that the school will start tomorrow, August 19, 2026. The hours of operation are Monday to Friday, from 8:00 A.M. to 4:00 P.M. Incidental Medical Services (IMS) was discussed. Licensing fees are due on September 8, 2025, amounting to $242.00. At around 1:40 P.M., Lyle Tavernier, the site Coordinator arrived at the facility.
Indoor/Children’s Area
Child care center is clean, safe, sanitary and in good repair; floors of all rooms have a surface that is safe and clean, cleaning compounds are inaccessible, poisons are locked, furniture/equipment is in good condition. Indoor activity space for children is equipped with age-appropriate furniture and equipment including tables, chairs, and cubbies to meet children’s needs; Per Lead Teacher Ramirez, tables, chairs, and toys are sanitized every day and whenever needed. All play equipment and materials used by children are age-appropriate, each child has an individual or portable storage space (cubby, individually labelled with name) for his/her clothing and personal belongings. The facility has a working telephone.
Trash bins have tight fitting lids. Soiled and wet diapers are placed inside trash bins with lids located inside the bathroom. Children will bring their own bottled water. All materials and surfaces are toxic free and are inaccessible. There is no fireplace in the facility. The center has an internal pull-down fire alarm system, and it has a 3-A:40-B:C type of fire extinguisher. Carbon monoxide devices are in operable condition (tested at 3:11 P.M.)
Lady King
Joselito DelMundo
DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 6
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/18/2026
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Restrooms: LPA inspected and observed a total of 1 toilet and 1 sink in the bathroom. Staff members have a separate restroom to use. The LPA also observed liquid soap, toilet paper, trash bins with covers, and paper towels inside the bathroom. Water temperature is appropriate.
There is an isolation area in the corner of the room (book area) and parents are called to pick up their children. Once the child is picked, the area will be sanitized. The facility maintains a comfortable temperature at all times, first aid supplies, and electronic sign in/out sheets will be completed daily. Smoking is prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.
Napping: LPA observed sleeping cots for napping. Per Lead Teacher Ramirez, parents provide sheets to their children in care for nap time and the sheets are washed during Fridays. Sleeping mats are wiped/cleaned/sanitized, or when soiled and there is no contact with other children bedding.
Outdoor: The facility has a playground area for the preschool. Per Lead Teacher Ramirez, children used the outdoor playground in the morning between 10:30 A.M. to 11:30 A.M., depending on the weather. Children bring their own bottled water. The facility used cart to bring bottled water, children’s files, first aid kit, and other emergency supplies. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. LPA observed the shade has cover that was torn out. Per Lead Teacher Ramirez, they will replace the cover for the shade. LPA also observed one of the kitchen set toys is broken. Per Lead Teacher Ramirez, they will dispose of the kitchen set toy. LPA also observed one the play equipment upper part can be dismantled from the play equipment. Per Lead Teacher Ramirez, they will also discard the play equipment. LPA observed the play area where the slide is located has cushioning material to absorb a fall. No bodies of water were observed.

Health Related Services: According to Lead Teacher Ramirez, since the school has not started yet, they do not know if they have a child that will be needing IMS. Per Lead Teacher Ramirez, the Lead Teacher, will be trained to administer medications. Children will be inspected for illnesses (wellness policy) as they arrive. Per Lead Teacher Ramirez, children were physically observed when they arrive at the center.

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 (

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/18/2026
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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

Food Service: There is a clean microwave, refrigerators, and freezers available in the facility. Per Lead Teacher Ramirez, the morning snacks are provided at 10:30 A.M. and afternoon snacks are provided at 2:00 P.M.

Staff/Personnel Records: Director (qualified) qualifications were verified, Designation of Responsibility observed, immunization's, TB clearance for staff, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file. Staff 2 do not have CPR and First Aid training. Per Lead Teacher Ramirez, they were having a hard time finding a CPR training course for staff 2. Also, staff 2 is with the Lead Teacher when providing care and supervision to children in care. Facility Records: Roster, fire/disaster drills log was last completed on June 5, 2026, at 11:00 A.M. and at May 21, 2026, at 10:00 A.M. LPA checked Guardian and staff 1 and staff 2 are not showing on Guardian. and they were not associated to the facility. LPA checked each staff individual's name and it was determined that staff 2 was fingerprint cleared. LPA also checked staff 2 but LPA could not find any matching individual regarding staff 2. LPA contacted Sujey Prieto from the Mono County of Education, and it was verified that staff 2 is fingerprint cleared.Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393), PUB 269 Child Passenger Restraint System Poster, emergency disaster plan, and earthquake preparedness checklist.

Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.


Advisory/Other: First Aid kit boxes were observed with supplies and are readily available.
The facility will use electronic sign in and out (Brightwheel) daily. The parent board was reviewed and has all the required forms posted. The parent board was reviewed and has all the required forms posted. The facility has daily schedule.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
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/18/2026
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Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Lead Teacher was advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email

address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

The Lead Teacher was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test as specified in Health and Safety Code section 1597.16.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP.).

LPA verified that the lead testing was completed on 08/3/2023 in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP.

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

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/18/2026
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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 email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8:00 A.M. – 5:00 P.M.



No deficiency was cited at this time.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Lead Teacher, Jackie Ramirez.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC809 (FAS) - (06/04)
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