367750074-7-10-2025-12-CC-KZIS-DJFTMP-20250710145129

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367750074
Report Date: 07/10/2025
Date Signed: 07/10/2025 02:51:47 PM

Document Has Been Signed on 07/10/2025 02:51 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:	AZY'S PLACE		FACILITY NUMBER:	367750074
ADMINISTRATOR/ DIRECTOR:	LILIANA VELASQUEZ		FACILITY TYPE:	850
ADDRESS:	58967 BUSINESS CTR DR STE G-H		TELEPHONE:	(760) 288-9068
CITY:	YUCCA VALLEY	STATE: CA	ZIP CODE:	92284
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 15	CENSUS: 14	DATE:	07/10/2025
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:35 PM
MET WITH:	Facility Representative Liliana Velasquez		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On July 10, 2025, at 12:30pm., Licensing Program Analysts (LPA) Zirbes and Cha met with the Facility Representative Liliana Velasquez. The purpose of the inspection was to conduct a case management Annual Continuation inspection. LPA disclosed the purpose of the inspection to facility representative S5. Present during today’s inspection were five napping toddlers being supervised by staff 3 (S3), and nine preschool age children being supervised by the staff 4 (S4) and staff 5 (S5). Additional staff was on site supervising the eight school children. During this inspection LPAs reviewed six staff files and seven child files. All staff and child files were current and contained all required information. On 7/09/25, at approximately 1:51pm, LPA Zirbes and facility representative Velasquez toured the preschool classroom (Grand Hall). At the time of the tour, the children were napping. LPA observed the door to the classroom was open, and the supervising staff member, Lilly Velasquez, was sitting in a chair near the door way. When LPA entered the room, there were zero classroom lights on. LPA was unable to conduct a head count of the number of children in the room without the aide of the flashlight on her mobile device. From the entrance of the room LPA was unable to visually see all the napping children. When asked about the supervision during nap time, facility representative expressed the Center has night lights however the children express they can not sleep with the night lights. After the conversation, LPA observed the facility representative turn on one night light in the classroom, LPA also observed the facility representative use the flashlight on their mobile device to look around the classroom. Continued on page two

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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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Document Has Been Signed on 07/10/2025 02:51 PM - It Cannot Be Edited

Created By: Kendal Zirbes On 07/10/2025 at 02:05 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: AZY'S PLACE	FACILITY NUMBER: 367750074
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229(a)(1)

Responsibility for Providing Care and Supervision

(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above when due to a lack of lighting in the Grand Hall preschool classroom during nap time the staff are unable to visually observe all children, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/25/2025
	Plan of Correction
1 2 3 4	Per facility representative, additional lighting will be purchased and added out the classroom. A staff training will be completed on 7/25/25 along with receipts for the new lights.

Type B

Section Cited

101804(b)(2)

Care for Toddlers within a Licensed Preschool Center

(2) A ratio of six children to each teacher shall be maintained for all children in attendance in the toddler component. An aide who is participating in on-the-job training may be substituted for a teacher when directly supervised by a fully qualified teacher. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, and record review, the licensee did not comply with the section cited above when S2 an aide was alone and supervising one toddler age child in the Life Science Classroom, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/25/2025
	Plan of Correction
1 2 3 4	Per facility representative, a staff meeting will occur to discuss roles. An updated LIC 500 will be submitted to the Department.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Lady King
NAME OF LICENSING PROGRAM MANAGER:

	Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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: AZY'S PLACE	FACILITY NUMBER: 367750074
	VISIT DATE: 07/10/2025

NARRATIVE

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Report continued from page one

In November 2024 LPA and facility representative discussed the lighting and supervision of the preschool classroom. In November the Center purchased night lights to add to the room. Based on LPA observation, on 7/09/25, the Center was unable to provide visual observation of the children during nap time, no incidents occurred on 7/9/25, therefore a Type B citation was issued, refer to LIC 809D. Furthermore, on July 9, 2025 LPA and facility representative Velasquez observed Staff 2 (S2) alone and supervising one toddler child in the Life Science Room. Facility representative requested S2 take the child back to the classroom with the teacher S1. S2 was supervising the child for less than five minutes. On 7/10/25 LPA Zirbes conducted a review of S2 file. Based on LPA record review, S2 is an aide with zero early child education units. Therefore S2 must be directly supervised by a fully qualified teacher. When questioned about the observation, facility representative Velasquez expressed they did not know why S2 was supervising the child. A type B citation was issued.

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.
For child care 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 to the Written Directives outlined in PIN 21-21.1-CCP.

Facility representative 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.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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 are available at: https://www.ada.gov/resources/child-care-centers/. Report continued on page three

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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: AZY'S PLACE	FACILITY NUMBER: 367750074
	VISIT DATE: 07/10/2025

NARRATIVE

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Report continued from page two

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.

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.

As a result of this inspection, two type B citations were issued.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Liliana Velasquez. Appeal rights were provided

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

LIC809 (FAS) - (06/04)

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