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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700012
Report Date: 03/20/2025
Date Signed: 03/20/2025 02:49:22 PM

Document Has Been Signed on 03/20/2025 02:49 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:
157700012
ADMINISTRATOR/
DIRECTOR:		GARCIA, RITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 557-0617
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
03/20/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:18 PM
MET WITH:Rita Garcia, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:54 PM
NARRATIVE
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On Thursday, March 20, 2025, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced case management and met with licensee Rita Garcia who granted access and guided LPA Rivera on a tour of the facility. LPA observed 2 preschool children present and assistant present.

During LPA Rivera visit, LPA observed an adult present without a background clearance during operational hours and child care children present. Licensee stated the adult present does not have a background clearance. LPA informed any adults present during hours of operation and present child care children must have a background clearance. LPA Rivera provided the LiveScan application.

The deficiency listed on the following page was observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. One type A deficiency is being issued today for regulation 102370- Criminal Record Clearance- (a) Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption. Please see attached LIC 809-D for citation. Also a civil penalty has been issue for $100.00. Please see attached LIC 421BG.

Deficiencies that are being cited need to be cleared to protect the children’s health & safety. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted, and report was reviewed with the licensee Rita Garcia.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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Document Has Been Signed on 03/20/2025 02:49 PM - It Cannot Be Edited


Created By: Mayra Rivera On 03/20/2025 at 02:31 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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 157700012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/31/2025
Section Cited
HSC
102370

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Criminal Record Clearance-(a) Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption. This requirement is not met as evidenced by:
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Licensee stated, will have the adult to go and get finger printed tomorrow friday, 3/20/25.
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Based on LPA Rivera observation and licensee statement of adult present not having a background clearance. The facility did not comply with the section cited above in being over ratio which poses an immediate health, safety or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Mayra Rivera
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2025


LIC809 (FAS) - (06/04)
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