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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830201
Report Date: 06/06/2025
Date Signed: 06/06/2025 09:48:58 AM

Document Has Been Signed on 06/06/2025 09:48 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:BARAJAS FAMILY CHILD CAREFACILITY NUMBER:
364830201
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
06/06/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Licensee, Erika Barajas TIME VISIT/
INSPECTION COMPLETED:
10:05 AM
NARRATIVE
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On June 6, 2025, at 08:20am, Licensing Program Analyst (LPA) Zirbes conducted an unannounced case management Licensee initiated inspection. The Department received a capacity increase request from the Licensee on April 3, 2025. An approved fire clearance was received on June 5, 2025, with an approval date of May 27, 2025. Upon LPA arrival today, there were three children in care (two school age, one preschool) with the Licensee providing supervision. Based on LPA observation the facility was within ratio
According to the Licensee, at this time there are two adults (Licensee and Adult 1) and zero minor children residing in the home. All family members are associated and have eligible background clearances. According to the Licensee the operating hours are Monday to Friday from 6:00 a.m. to 6:00 p.m. and the Licensees provides care for children ages zero to 13.
Physical Plant: This is a single story home with 4-bedrooms, 2-bathrooms, kitchen, dining, backyard and garage/laundry room. According to the Licensee, there are zero bodies of water on the property along with zero weapons.
Off limit areas of the home: All bedrooms, the office, primary bathroom, garage/laundry room.
On limit areas of the home: Living room, kitchen, dining room, family room, bathroom (located in the hallway) and the backyard.
LPA Zirbes inspected the family child care for safety, comfort, cleanliness, ventilation and working phone (cell phone and landline). LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA observed a fireplace in the living room, Access to the fireplace was blocked by a couch. LPA Zirbes observed cleaning compounds stored in bathroom and kitchen cabinets equipped with magnetic child safety locks. LPA observed the knives and sharp objects were also stored in cabinets equipped with child safety locks. LPA advised the Licensee to ensure the magnetic key was inaccessible to the children in care. Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2025
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: BARAJAS FAMILY CHILD CARE
FACILITY NUMBER: 364830201
VISIT DATE: 06/06/2025
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Report continued form page one
Outdoor: The outside play area was clear of chemicals and debris, LPA observed age appropriate toys and play equipment, and the entire yard is fenced.

At the time of this inspection there were five dogs on the property who were interacting with the childcare children.

During this inspection LPA and Licensee discussed the capacity and ratio requirements for a large family child care. According to the Licensee, at this time an assistant has not been hired. LPA and Licensee discussed the requirements for a qualified assistant. LPA advised the Licensee to refer to the LIC 311D for a guide regarding the documents required to be maintained in the staff files. Licensee was made aware that it is his/her/their responsibility to know the regulations as well as anyone who assists in providing care.



LPA reviewed the Licensee file, and verified the Licensee has current mandated reporter training with an expiration date of 04/02/2026 and a Pediatric First Aid/CPR training with an expiration date of 04/26/2027.

As a result of this inspection, zero citation were issued.

Licensee was information that approval of the capacity increase is pending final review by a Licensing Program Manager.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Erika Barajas.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025
LIC809 (FAS) - (06/04)
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