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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 147700016
Report Date: 07/25/2025
Date Signed: 07/25/2025 12:05:03 PM

Document Has Been Signed on 07/25/2025 12:05 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MOSQUEDA FAMILY CHILD CAREFACILITY NUMBER:
147700016
ADMINISTRATOR/
DIRECTOR:		MOSQUEDA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 258-1075
CITY:BishopSTATE: CAZIP CODE:
93514
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/25/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:41 AM
MET WITH:Maria Mosqueda, Licensee TIME VISIT/
INSPECTION COMPLETED:
12:16 PM
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On 07/25/2025, Licensing Program Analyst (LPA) Justeene Tamayo conducted an unannounced annual random inspection. LPA disclosed the purpose of the inspection and was granted entry by the Licensee. The Licensee guided the LPA on a tour of the home. Upon entry to the facility, the LPA observe 8 children in care (5 school age children, 1 preschool child, and 2 infants), licensee, and assistant #1 providing care and supervision (fingerprint cleared and associated to the facility). Licensee's facility child roster is current and maintained up to date. There are no IMS children. The operational childcare hours are Monday through Friday from 7am to 5:30pm. There is a pond at the front entrance. The front entrance is not used to enter the home (Declaration provided during initial visit from 08-02-2018). Per licensee, no day care children go through the front door, and are only allowed to go through the side latched gate in the back. Children and parents enter from the side entrance gate (enters to the backyard). No other bodies of water were observed. Adults residing in the home include 2 adults (licensee and licensee's adult son) and no minor children.

This is a one-story family home. There is a living room (daycare area), dining room (daycare area), kitchen, two bedrooms, one bathroom, and backyard. The off-limits areas are the two bedrooms, hallway closet, furnace area in kitchen, and the front yard. In the daycare area there are cubbies for the children belongings can be placed. Parent board is posted in dining room area. Licensee did show the required documents to LPA. Licensee had all the required posted documents: Facility License (LIC 203A, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148).
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOSQUEDA FAMILY CHILD CARE
FACILITY NUMBER: 147700016
VISIT DATE: 07/25/2025
NARRATIVE
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Physical Plant: Daycare area is the living room and dining room first room on the right next to the front door. Licensee does provide snacks for the children morning and afternoon snacks. The children bring packed lunches. Lunchboxes are placed in the refrigerator for the children in care. Licensee is not in the food program. 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. There are no window blind cords on the windows. Per licensee she no longer has her two dogs on premises. There is no working landline. Licensee utilizes her cell phone which is always charged and kept on her. There are age-appropriate toys and equipment on the premises. The First Aid kit included a temperature thermometer, tweezer, scissors, gauzes, and cleansing pads/solution was observed to be complete and inaccessible to children kept high in the kitchen. The children enter facility from the backyard through self-latching gate. The facility is a larger capacity licensee of 14.

Napping: Children are provided napping daily. They use their own blankets to lay on the floor for napping. Blankets are washed weekly. Isolation area is on the couch near the front door away from other children.

Transportation: The licensee does provide transportation. Licensee pick/drop off children from there from home at times and from school.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOSQUEDA FAMILY CHILD CARE
FACILITY NUMBER: 147700016
VISIT DATE: 07/25/2025
NARRATIVE
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Kitchen: LPA observed a safety gate barricading the entire kitchen area. Knives are kept in the kitchen in a high cabinet safety latched next to sink, inaccessible to children in care. Medication is kept in the kitchen in a safety latched high cabinet near sink inaccessible to children in care. Cleaning supplies and chemicals are kept under the kitchen sink with safety latch on it. Per licensee, no day care children have food allergies at this time.

Fire Extinguisher: The required fire extinguisher (2A10BC) is reading in green and in located on the kitchen wall. The fire extinguisher was last serviced on 04/2025. Fire alarm was in operable condition, however licensee needed to change the batteries for the carbon monoxide (technical violation given). Carbon monoxide is now in operable condition per LPAs observations. LPA reminded licensee to ensure carbon monoxide detector and smoke detector are operable at all times during operation hours.
Fire and Disaster drills are conducted at least every six-months, last drills were recorded on 06/10/2025 . First aid kit located in the kitchen on the mid self in off limits area.

Bathroom: The daycare bathroom is in the daycare classroom. It has 1 sink, 1 toilet and 1 shower. Bathroom is clean and in good repair. No hazardous items were observed in the childcare bathroom.

Outdoor Space Activity: The outdoor area is in the back yard. The front yard is off limits. The back yard is free of broken toys/furniture & equipment, and other debris. LPA did not observe any pools or bodies of water, however licensee does have a wading pool that is emptied after each use after water activities are conducted with the day care children. LPA reminded licensee to ensure water is always emptied after each use.
There is a chain link fence that is an off-limits backyard located on the left side of the home where shovels and other hazardous items are kept. The fence is locked. There is a self-latching gate in backyard for entrance to facility daycare. Per the Licensee, there is no smoking and no weapons on the premises.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOSQUEDA FAMILY CHILD CARE
FACILITY NUMBER: 147700016
VISIT DATE: 07/25/2025
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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/.
MyChildCarePlan.org – Family Child Care Homes
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Megan’s Law - Family Child Care Homes
During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Facility has been cited one Type B Citation and 2 Technical Violation during today's visit.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Maria Mosqueda, along with a copy of her appeal rights and Notice of Site Visit.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOSQUEDA FAMILY CHILD CARE
FACILITY NUMBER: 147700016
VISIT DATE: 07/25/2025
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Records/Documentation: LPA reviewed with facility representative the LIC 311A, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. Licensee's Pediatric CPR/First Aid expires on 06/22/2026. Licensee's mandated reporter training expires on 06/13/2026.

During file review of child #7 records, licensee only had child #7 proof of immunization's, and did not have the rest of child #7 licensing child forms or file. Licensee will have task completed and send proof of completion to LPA Tamayo no later than 08/08/2025 via email. Facility has been cited a Type B Citation. Please see LIC809-D for deficiency page.

Criminal Record Clearance - Family Child Care Homes
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.

Safe Sleep - Family Child Care Homes
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-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for 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 equipment.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/25/2025 12:05 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 07/25/2025 at 11:53 AM
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: MOSQUEDA FAMILY CHILD CARE
FACILITY NUMBER: 147700016

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(b)
Child's Records
(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Child #7 did not have proof of emergency information, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/08/2025
Plan of Correction
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Licensee will send proof of documentation to LPA Tamayo no later than 08/08/2025.
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:
Justeene Tamayo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2025


LIC809 (FAS) - (06/04)
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