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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700305
Report Date: 05/06/2026
Date Signed: 05/06/2026 03:42:23 PM

Document Has Been Signed on 05/06/2026 03:42 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:LOBOS FAMILY CHILD CAREFACILITY NUMBER:
367700305
ADMINISTRATOR/
DIRECTOR:		MARTHA LOBOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 974-7577
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
05/06/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:09 PM
MET WITH:Martha Lobos; LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On May 6, 2026, Licensing Program Analyst (LPA) Hanna Cha met with Licensee Martha Lobos. The purpose of the visit was to conduct an unannounced Annual/Random inspection of the facility. Upon arrival, Assistant #1 (A1) granted entry to LPA. LPA disclosed the purpose of the inspection to A1 and toured the facility.

Upon arrival, LPA observed only A1 providing care to four infants, one preschool-age child, and two school-age children for a total census of seven children. Upon arrival, LPA inquired if Licensee was present. Per A1, Licensee was not present in the home. Licensee immediately informed A1 to contact Licensee. During the inspection, one school-age child was picked up from the facility for a total census of six children. Licensee arrived at the facility approximately 20 minutes after LPA. Per Licensee, Licensee was absent for "about an hour" due to an emergency. LPA informed Licensee that at time of LPA arrival, the facility was operating above capacity requirements. LPA informed Licensee that with one adult, the facility must adhere to the capacity requirements of a small family child care home, with no more than six children. A Type A citation issued. See 809-D.

Per Licensee, adults residing in the home are Licensee, one adult child, and an additional adult child on occasion. LPA verified fingerprint clearances for all adults. The current days and hours of operation are Mondays to Fridays; 6:00am-5:30pm.

Physical Plant: Main child care is provided in the playroom, family room, den, bathroom (located within the playroom). The off-limit areas are all bedrooms, laundry room, garage, kitchen, front yard, and back yard which includes an in-ground pool. The off-limit areas made inaccessible via baby gates and locked sliding doors.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2026
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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Document Has Been Signed on 05/06/2026 03:42 PM - It Cannot Be Edited


Created By: Hanna Cha On 05/06/2026 at 02:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 367700305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, LPA observed only Assistant #1 (A1) providing care to four infants, one preschool-age child, and two school-age children for a total census of seven children. Upon arrival, LPA inquired if Licensee was present. Per A1, Licensee was not present in the home. Per record review, A1 did not have a current Pediatric CPR/FA, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/07/2026
Plan of Correction
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Licensee will review the Capacity Chart and provide a Declaration (LIC 855) indicating that Licensee understood the capacity requirements and will not exceed the capacity requirements moving forward by POC due date, 05/07/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mariela Ramon
NAME OF LICENSING PROGRAM MANAGER:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/06/2026 03:42 PM - It Cannot Be Edited


Created By: Hanna Cha On 05/06/2026 at 02:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 367700305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, Assistant #1 (A1) proof of immunizations (MMR, Tdap) not included in file at time of inspection which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/20/2026
Plan of Correction
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LPA informed Licensee that all personnel files must include proof of immunizations (MMR, Tdap). Licensee will provide proof of A1 immunizations to the department by POC due date.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, children files for Child #1 (C1) and Child #2 (C2) did not include immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/20/2026
Plan of Correction
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Licensee will provide proof of immunization records on file for C1 and C2 to the department by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mariela Ramon
NAME OF LICENSING PROGRAM MANAGER:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2026


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: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 367700305
VISIT DATE: 05/06/2026
NARRATIVE
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Indoor Child Care Areas: LPA inspected the child care areas for age-appropriate toys/equipment, safety, and good repair. The carbon monoxide alarm and smoke alarm observed. LPA observed fire extinguisher (2A10BC), fully green. The kitchen made inaccessible by two child safety gates. LPA reminded licensee, if food is brought from the child’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Licensee provides all meals during operational hours. Per licensee, there is no smoking in the home. Per licensee, no firearms/weapons on premises.

Pool/Bodies of Water: Per LPA observation, there is an in-ground pool in the back yard. The back yard is made off-limits by a locked sliding door. At time of inspection, LPA verified that the sliding door was locked. LPA observed mesh fencing with one gate that provides access to the in-ground pool. The fence was 60 inches in height. The fence does not obscure the pool from view. The vertical clearance from the ground to the bottom of the enclosure did not exceed two inches. There were no gaps or voids wider than 4 inches. LPA tested the gate to swing away from the pool, self-close, self-latch, and have a key-lockable device placed no lower than 60 inches above the ground. At time of inspection, the gate was key-locked.

Per LPA observation, a pool alarm was observed in the water at time of inspection. However, the pool alarm was not turned on. LPA informed A1 to turn on the pool alarm. LPA verified that the pool alarm was operable once turned on. Per Licensee and A1, the pool alarm was turned off due to the "pool guy" who visited the facility to provide pool maintenance. Per A1, the "pool guy" left at approximately 11:30am. LPA arrived at approximately 12:10pm. LPA informed Licensee that pool alarm must be turned on and in operating order during all child care hours. A Technical Violation issued.

At time of inspection, LPA observed the body hook hung on the mesh fence. However, the body hook was not attached to the fixed 12-foot rescue pole. The rescue pole was attached to a pool net, at time of inspection. LPA informed Licensee that body hook must be attached to the rescue pole. During the inspection, Licensee attached the body hook to the rescue pole. A Technical Violation issued.

LPA observed a life ring approved by the U.S. Coast Guard with a minimum exterior of 17 inches. LPA informed licensee of the requirement to document daily pool checks and verified documentation. Licensee shall ensure that there are no climbing aids around the fence that could be used as a handhold or foothold for children to climb. LPA informed licensee that the pool requirements will remain in place whenever licensed care is provided, and so long as the requirements make the pool inaccessible to children as determined by the licensing department.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
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: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 367700305
VISIT DATE: 05/06/2026
NARRATIVE
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File Review: LPA reviewed Licensee and Assistant #1 (A1) files. LPA verified a valid Pediatric CPR/FA certification only for Licensee. Per record review, Assistant #1 (A1) proof of immunizations (MMR, Tdap) not included in file at time of inspection. LPA informed Licensee that all personnel files must include proof of immunizations (MMR, Tdap). Licensee will provide proof of A1 immunizations to the department by POC due date. A Type B citation issued. See 809 D.

LPA reviewed seven children files. Per record review, files for Child #1 (C1) and Child #2 (C2) did not include immunization records. Per Licensee, immunization records were received. However, Licensee was unable to present the documents to LPA for review at time of inspection. Licensee will provide proof of immunization records on file for C1 and C2 to the department by POC due date. A Type B citation issued. See 809 D.

Documents Provided: Entrance Checklist (LIC 126), Declaration (LIC 855), Acknowledgement of Receipt of Licensing Reports (LIC 9224), Capacity Chart, Appeal Rights

Any Type A citation (s) and/or documents verifying compliance or non-compliance must be posted for 30 days during all hours of operation. Applicant shall provide a copy of Type A citation(s) to parents/guardians of all children enrolled by the next business day and to newly enrolled parents/guardians for 12 months from the date of the report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) or other written statement must be placed in the child's file for verification. Failure to do so will result in a civil penalty. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. Per the Health and Safety code (HSC) 1596.859, 1596.8895, and 1597.05 to improve transparency of licensing records and to notify parents/guardians.



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.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
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: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 367700305
VISIT DATE: 05/06/2026
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations. Also, to enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report (LIC624B) when submitting a report to the department at: 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 (7) days following the occurrence of any events specified above.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
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: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 367700305
VISIT DATE: 05/06/2026
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee 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.

During the exit interview, the Licensee Martha Lobos confirmed that there are no Registered Sex Offenders living in the facility and LPA completed an RSO check on FAS.

During this inspection, one Type A citation, two Type B citations, and two Technical Violations issued. See 809-D.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Martha Lobos.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026
LIC809 (FAS) - (06/04)
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