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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844539
Report Date: 07/15/2025
Date Signed: 07/15/2025 05:04:29 PM

Document Has Been Signed on 07/15/2025 05:04 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
364844539
ADMINISTRATOR/
DIRECTOR:		GARCIA, DEBORAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 965-9534
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
07/15/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:40 PM
MET WITH:Licensee Deborah Garcia TIME VISIT/
INSPECTION COMPLETED:
05:10 PM
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On July 15, 2025, at 02:40 p.m., Licensing Program Analyst (LPA) Kendal Zirbes met with Licensee Deborah Garcia and Facility Representative Maria Tafolla. The purpose of the inspection was to conduct a annual/Random inspection at the licensed facility. LPA disclosed the purpose of the inspection to the Licensee. When LPA arrived to the facility, the Licensee and facility representative were providing supervision to eleven children (two infants, four preschool and five school age children). Currently living in the home are five adults and two minor children. All adults are associated and have eligible clearances. Current days and hours of operation are Monday through Sunday, 24 hours a day. Licensee understands that care can not be provided for more than 23 hours a day per child.
Physical Plant: This is single story home with five bedrooms, three bathrooms, kitchen, living room, laundry room, front/backyard with a pool and detached garage. Per Licensee the kitchen, one bathroom (located down the hallway), living room, and backyard are utilized for the family child care activities. The off-limits areas consists of all five bedrooms, two bathrooms, laundry room, detached garage. The off limits areas were inaccessible via locked doors and child safety door knobs covers. The home has a fire place in the living room. The fireplace had a mesh screen at the time of this inspection. The home has central heating and air conditioning. 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 a danger to children. According to Licensee all cleaning products are stored the cabinet under the kitchen sink. The cabinet was equipped with a child safety locks. Sharp knives were stored in a high kitchen cabinet that was inaccessible. Household medications are in a kitchen cabinet equipped with a child safety lock. Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539
VISIT DATE: 07/15/2025
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Report continued from page one

Per documentation on the fire extinguisher the fire extinguisher was last serviced in 2022. When asked about the servicing of the fire extinguisher, the Licensee and Facility Representative confirmed the fire extinguisher had not been serviced since 2022 and a new fire extinguisher has not been purchased within the past year. Based on LPA record review and interviews the fire extinguisher does not meet the State Fire Marshall standards. A technical violation was issued. LPA and Licensee discussed the State Fire Marshall Requirements. Safe and age appropriate toys, play equipment and materials were present. Smoke detector and carbon monoxide detector were tested and found to be in operating condition at this time. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. The living room is the designated area for ill children in the child care.
Bathroom (located down the hallway): Toilet, sink, faucet, shower were clean and operable. The following were inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish.
Outdoor: The backyard is divided into off limit and on limit areas. The on limit area was completely enclosed by a fence. LPA advised the Licensee that children must be constantly supervised when transitioning between the on limit outdoor space and the off limit areas. There is a in-ground pool in the backyard. The pool is surrounded by a 5’ removable mesh fence that is mounted into concrete. There was one gate that provide access to the in ground pool. The mesh gate was observed to be self closing and self latching with a key lockable device. LPA observed there are zero items around the perimeter of the fence that would allow the fence to be climbable. LPA observed a life ring with a minimum exterior diameter of 17 inches hanging in the pool area. Per LPA observation the life ring was not labeled as approved by the United States Coast Guard. LPA and facility representative reviewed the paperwork for the life ring. Per documentation review, the life ring was not approved by the United States Coast Guard. Based on LPA record review and observation the life ring did meet regulation 1596.814(a)(2)(B). LPA observed a 12 foot rescue pool with body hook attachment. LPA observed a pool alarm placed in the pool. The pool alarm was tested and found to turned on and in working condition. LPA heard the alarm make an audible sound inside the home. At the time of this inspection, the Licensee was able to provide documentation that the alarm was compliant with ASTM International Standard F2208.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539
VISIT DATE: 07/15/2025
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Report continued from page two

LPA asked the Licensee if they had been performing a daily inspection of the safety equipment and the drowning prevention safety features. Licensee expressed they check the outdoor area every morning however a log of the inspection is not being maintained. LPA discussed the requirement with the Licensee. A Technical violation was issued. The licensee understands and agrees that the mesh fence will remain in place whenever licensed care is provided.

Per Licensee, there is one cat on the property which interacts with the child care children.


Due to time constraints, LPA was unable to complete the entire inspection. LPA will return on a future date to complete the inspection.

Based on LPAs record review there was two technical violations issued today.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Deborah Garcia.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC809 (FAS) - (06/04)
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