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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700074
Report Date: 03/20/2025
Date Signed: 03/20/2025 12:30:15 PM

Document Has Been Signed on 03/20/2025 12:30 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:JAIME FAMILY CHILD CAREFACILITY NUMBER:
157700074
ADMINISTRATOR/
DIRECTOR:		AYDE JAIMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 436-9414
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/20/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Ayde Jaime, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:45 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 Ayde Jaime who granted access and guided LPA Rivera on a tour of the facility. LPA observed 4 preschool children present and with assistant present.

On January 13, 2025, during an inspection, LPA Rivera observed the LIC 9040 Roster to have 12 children enrolled. During the interview of January 13, 2025, licensee stated has 12 children enrolled and licensee provided LPA 12 children files. Based on the evidence of Community Connection for Child Care and CAPK Migrant Child Care program timesheets it reveled, licensee had up to 25 children enrolled. Licensee Ayde Jaime , withhold information and was not truthful when LPA asked about children enrollment and files.

The deficiency listed on the following page was observed by the LPA Rivera and is being cited in accordance with Health and Safety code 1596.885(c). Conduct Inimical-Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. One type A deficiency is being issued today for regulation. Please see attached LIC 809-D for citation.



Deficiency that is 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 Ayde Jaime.
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 12:30 PM - It Cannot Be Edited


Created By: Mayra Rivera On 03/20/2025 at 12:08 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: JAIME FAMILY CHILD CARE
FACILITY NUMBER: 157700074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/21/2025
Section Cited
HSC
1596.885(c).

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). Conduct Inimical-Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. Based on the interview and evidence provided, . Licensee Ayde Jaime, withhold information and was not truthful when LPA asked about children enrollment and files.
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Licensee Ayde provided an updated LIC 9040 with all children who are currently enrolled and or left the facility.
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information and was not truthful when LPA asked about children enrollment and files. The facility did not comply with the section cited above 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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