360910831-7-16-2026-12-CC-KCAY-DW2TP3-20260716145339

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360910831
Report Date: 07/16/2026
Date Signed: 07/16/2026 02:53:46 PM

Document Has Been Signed on 07/16/2026 02:53 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	PSD/APPLE VALLEY HEAD START		FACILITY NUMBER:	360910831
ADMINISTRATOR/ DIRECTOR:	MAGDALENA LOZANO		FACILITY TYPE:	850
ADDRESS:	13589 NAVAJO ROAD		TELEPHONE:	(760) 247-6955
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92308
CAPACITY: 117	TOTAL ENROLLED CHILDREN: 117	CENSUS: 11	DATE:	07/16/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:43 PM
MET WITH:	Erica Robinson		TIME VISIT/ INSPECTION COMPLETED:	03:10 PM

NARRATIVE

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On July 17, 2026, at 1:43 PM., Licensing Program Analyst (LPA) Calloway, made an unannounced case management inspection to the above facility. The purpose of the case management was to follow up on a self-reported Unusual Incident Report (UIR) submitted to the Palmdale Regional Office on April 10, 2026. LPA met with Erica Robinson, site supervisor as the new representative and toured the two classrooms and playground with the representative and observed eleven preschool children and four staff. All adults 18 years and over have Criminal Record Clearance and Child Abuse Central Index Clearance and are associated with the facility.

On April 7, 2026, the reported information stated playground renovations will start on April 7, 2026, and the approximate construction completion dates are projected for June 30, 2026. Children will be provided gross motor activities inside such as dancing, yoga, jumping, balance beams, parachute, scavenger hunt, bean bag and ring toss and parents were notified of the construction.

At 2:00 PM, LPA and the representative toured the playground and there were two large play structures as play equipment, each with a large slide and climbing areas, and steps with a height appropriate for the age group of children and a rubber mat as a cushioned surface. There was a crawl tunnel, swing set, play house, biking trail, and two teeter totters and all of the equipment was anchored in the ground. There was a separate large canopy with artificial grass that will have furniture and will be used for activities. The sand pit area was removed. LPA observed the tables and benches that will be used in the area, and they are age appropriate and at the right height. The playground is enclosed by a chain-linked fence and privacy screening to protect children and to keep them in the outdoor activity area that was at least five feet tall. The representative stated the play structures and play ground will be shared with four preschool classrooms.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PSD/APPLE VALLEY HEAD START	FACILITY NUMBER: 360910831
	VISIT DATE: 07/16/2026

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The children are able to reach the outdoor activity area safely from the preschool classroom. The playground was free of debris and there were no hazards observed. Upon review of the playground, it meets the standards under the Title 22 regulations CCR.

An exit interview was conducted, and a copy of this report was read, a Notice of Site Visit (LIC 9213), were given to Erica Robinson, representative at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC809 (FAS) - (06/04)

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