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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810042
Report Date: 04/30/2026
Date Signed: 04/30/2026 12:55:20 PM

Document Has Been Signed on 04/30/2026 12:55 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:SBCUSD-HILLSIDE PRESCHOOLFACILITY NUMBER:
364810042
ADMINISTRATOR/
DIRECTOR:		LATASHIA KELLYFACILITY TYPE:
850
ADDRESS:4975 MAYFIELD AVENUETELEPHONE:
(909) 730-3674
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
04/30/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Stephanie Robles - Lead TeacherTIME VISIT/
INSPECTION COMPLETED:
12:55 PM
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On Thursday, April 30, 2026, at 9:50am, Licensing Program Analyst (LPA) Giovanni Cristales met with Lead Teacher Stephanie Robles, who guided the analyst on a facility tour for the purpose of conducting an Annual/Random inspection for the daycare center with a capacity of up to 24 children. This is a State PS Program conducted on the grounds of Hillside Elementary School in a modular. Upon arrival, LPA observed a total of 20 preschool children. There was one (1) teacher and two (2) assistants on the premises. LPA observed the classroom to be within ratio. All staff have been fingerprinted and associated with the facility license number. The facility operates Monday - Friday from, 8:20 am 11:20 am and 12:20 pm to 3:20 pm in Rm PS#16. The preschool classroom has a separate exit and entrance from the elementary school.

Indoor/Children’s Area:
The childcare center was toured and found to be clean, safe, sanitary and in good repair to ensure the safety and well-being of children, employees, and visitors; All outdoor and indoor passageways, open areas of potential hazard are kept free of obstruction; heating, lighting, and ventilation are adequate, proper room temperature; floor (rug and tile) has a surface that is safe and clean, (Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored in locked storage room or in upper shelves), furniture/equipment are in good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent storage space (cubby, individually labelled with name) for his/her clothing, personal belongings. Trash cans for solid waste located outside the classroom have lids. Inside trash cans do not have lids, only used for paper towel purposes, drinking water is readily available indoors in the form of a water fountain dispenser. There is working telephone service on the premises. There is an isolation area for children who become ill while in care located in the office room.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2026
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: SBCUSD-HILLSIDE PRESCHOOL
FACILITY NUMBER: 364810042
VISIT DATE: 04/30/2026
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Bathroom: LPA inspected and observed two (2) bathrooms within the classroom. Each bathroom consists of one (1) toilet and one (1) sink. Toilets and sinks function properly and are age appropriate. LPA observed the bathrooms to be clean and sanitary with soap, toilet paper, and paper towels readily available. There is an additional age-appropriate sink located within the classroom. Staff use a separate restroom located in the main building.

Napping: Children do not nap at this site as the program is composed of two half day programs.

Food Service: The elementary school cafeteria prepares and provides breakfast and lunch and is brought over daily.
Menus were observed and posted on the parent board. Per lead teacher there are two children with allergies. LPA observed the allergy list.

Outdoor play: The facility has two (2) playground areas. Equipment was inspected for health, safety, good repair, hazards, and age appropriateness. The playing area was observed to be free of debris, free from hazard, holes, broken items, and debris. Center utilizes rubber matting under climbing structure for cushioning, and concrete for proper play. There is one (1) patio overhead canopy shade structure. LPA observed a large climbing sliding structure secured to the ground. Outside Drinking water is available in the form of a water fountain dispenser. There are no bodies of water observed on the premises. The entire playground is enclosed (metal fencing) to protect children and to keep them in the outdoor activity area. Per leading teacher, there is a second playground located on the back, which is currently not being used due to maintenance.

Other: Fire/earthquake drills are current (4/30/2026). Fire extinguishers 3A40BC (last served 4/1/026), and smoke detectors in classroom are operable.

First Aid Kit located towards the second exit door, was observed to be full and accessible (thermometer, bandages, gauze, scissors/tweezers). LPA observed sign in and out sheets (electronically) and roster personnel to be current. Per director, transportation is not provided for children currently.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The parent board was reviewed and has all the required forms posted. The following were observed posted as required: Facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393L), menus, car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SBCUSD-HILLSIDE PRESCHOOL
FACILITY NUMBER: 364810042
VISIT DATE: 04/30/2026
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Staff/Personnel Records: Staff file review reveals staff are qualified for their perspective positions. LPA reviewed three (3) staff files, and three (3) children files. CPR/First Aid, TB clearance, health screening, criminal record statement, statement acknowledging suspected child abuse, and employee rights were observed in each staff’s file. Staff #1 CPR/First Aid, Expires: 3/9/2027, and Mandated Reporter Expires: 7/24/2026.

The following general information was discussed during this inspection:

The director was advised of the requirement to report Unusual Incidents. The licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624 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 the daycare center. In addition, a written report shall be submitted to the department within seven (7) days following the occurrence of any events specified above.

All staff are required to take 3-hour Child Care Provider Mandated Reporter training (AB1207) every 2 years. Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors, and employees to complete training as specified in their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition of 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.

The director is aware self, and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000. For additional information and forms visit our website at: www.cdss.ca.gov

Criminal Record Clearance- CCC - Facility representative 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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SBCUSD-HILLSIDE PRESCHOOL
FACILITY NUMBER: 364810042
VISIT DATE: 04/30/2026
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Lead Testing- CCC 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 childcare 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 in accordance with the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information).

CCC COMPLETED TESTING (1/3/23) WITH NO LEAD EXCEEDANCES

Safe Sleep - CCC LPA discussed the safe sleep regulations with the facility representative and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep,as an additional resource. LPA also informed facility representative of the importance of checking for and removing any 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.

Incidental Medical Services (IMS)- CCC Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When 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) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/. When the facility provides IMS, the storage and medication supplies are kept inside bathroom #2 inside of red cross metal box with key lock.

MyChildCarePlan.org – CCC Facility representative 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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SBCUSD-HILLSIDE PRESCHOOL
FACILITY NUMBER: 364810042
VISIT DATE: 04/30/2026
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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.

No deficiencies are being cited in today’s visit. Notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with lead teacher Stephanie Robles, along with a copy of her appeal rights.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC809 (FAS) - (06/04)
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