197413421-1-16-2026-12-CC-KCAY-DQDQSE-20260116112524

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413421
Report Date: 01/16/2026
Date Signed: 01/16/2026 11:25:55 AM

Document Has Been Signed on 01/16/2026 11:25 AM - 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:	CEDARCREEK STATE PRESCHOOL		FACILITY NUMBER:	197413421
ADMINISTRATOR/ DIRECTOR:	DIANNA GONZALEZ		FACILITY TYPE:	850
ADDRESS:	19409 CEDARCREEK STREET		TELEPHONE:	(661) 294-5311
CITY:	CANYON COUNTRY	STATE: CA	ZIP CODE:	91351
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 15	DATE:	01/16/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Guadalupe Grijalva		TIME VISIT/ INSPECTION COMPLETED:	11:25 AM

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 January 16, 2026, Licensing Program Analyst (LPA) Calloway made an unannounced inspection to the above facility for the purpose of conducting an Annual Random inspection. LPA met with Guadalupe Grijalva, Facility Representative who granted access. LPA and representative toured the facility inside and outside. LPA observed fifteen active day care children aged three- four years old and four staff. The facility is open from 8:30 am to 12:00 pm. Monday-Friday. All employees over 18 years or older that are working or volunteering have a Criminal Record Clearance (DOJ/FBI) and Child Abuse Central Index Clearance and are associated with the facility. Physical Plant: There are two clean and safe classrooms. Representative stated one classroom is used primarily for the preschool during the day and the other class room is used for the school aged children in the afternoon that is license exempt and separate from the preschool. The telephone service, heating, ventilation, and lighting are adequate. The daily schedule and activities were posted. There are cubbies for children's belongings that are labeled with their names in the preschool classroom. The furniture, books, equipment, toys, and materials were appropriately aged and in good condition. There were activity rugs inside the room for play. Representative stated the rugs are cleaned three times a year. The drinking water is available inside the classrooms in the form of water labeled or disposable cups. Representative stated the cups are taken home daily. There is no napping. First Aid Kits were in each classroom in a red backpack. There is an Emergency Survival Kit kept in a container on the main school playground. LPA did not observe it. Trash cans have secure lids. The temperature inside the room was comfortable.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 7

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)

Page: 2 of 7

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: CEDARCREEK STATE PRESCHOOL	FACILITY NUMBER: 197413421
	VISIT DATE: 01/16/2026

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
26
27
28
29
30
31
32

Representative stated the fire extinguishers, smoke detectors and carbon monoxide detectors throughout the day care center are all operable and were checked during the last fire inspection.
Bathrooms: There are two separate bathrooms for the children. The girl’s bathroom had three stalls, three toilets, and two hand washing sinks. The boy’s bathroom had three stalls, two toilets and one urinal, and two hand washing sinks that are all functioning properly and at the appropriate height. LPA did not observe any accessible hazards. There was soap, toilet paper, and paper towels available. The staff restroom is inside the kitchen.
Kitchen: There is a fully equipped kitchen with refrigerator, freezer, stove, oven, and sink. Representative stated the kitchen is used for storage and kept locked. It was clean and there were no accessible hazards observed. The facility receives snacks and meals from the school cafeteria. The menus are posted inside/outside the class. Representative stated there are no allergies this year. LPA observed a small amount of snacks and 1% milk in the refrigerator. The chemicals and cleaning supplies are kept separate from the food and are locked in the custodial closet outside of the kitchen. LPA observed the cabinet unlocked during the inspection. Representative stated there was a substitute custodian that left the cabinet unlocked. Outside: Outdoor play equipment was inspected for safety, cushioning material, good repair and is age appropriate. LPA observed a medium sized play structure securely anchored in the ground with a canopy for shade and a rubber mat as a cushioned surface. There is concrete for active play. The playground was observed to be free of debris. Drinking water is available in the form of disposable and labeled cups. Representative stated there are no bodies of water on the premises. LPA did not observe any. There was one storage shed that was observed locked. The fencing is chain-linked at least 6 ft high and was observed locked and is secure around the entire playground.
Other Review: Children and staff files were reviewed. Current Pediatric CPR/First Aid (expires: 1/2028). Representative stated transportation is not provided. Disaster Drills: Fire Drill was conducted: 12/2/25 and the Earthquake drill was conducted: 11/20/25. Representative stated the last facility fire inspection was conducted: December 2025.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

LIC809 (FAS) - (06/04)

Page: 3 of 7

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: CEDARCREEK STATE PRESCHOOL	FACILITY NUMBER: 197413421
	VISIT DATE: 01/16/2026

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
26
27
28
29
30
31
32

The child/parent roster was complete with all required information. The staff/ child ratios were observed to be compliant; the sign in/out sheets were paper and legible. Representative stated the children are inspected for illnesses as they arrive. There is a separate isolation area for ill children inside the site supervisor's office until the parent can pick up the child. Representative stated medication is not being provided this year. LIC 125 form was discussed.

The following was discussed with the Representative:
Access the CCLD Licensing website at www.ccld.ca.gov. to obtain information about the most recent regulatory changes and the Quarterly Updates. Report any director or staff changes within ten (10) days. All representatives are responsible for knowing the regulations when providing care. All employees should know their role and responsibilities of being a Mandated Reporter. Training is renewed every two years at: mandatedreporterca.com. All adults 18 years 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.

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/.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

LIC809 (FAS) - (06/04)

Page: 5 of 7

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: CEDARCREEK STATE PRESCHOOL	FACILITY NUMBER: 197413421
	VISIT DATE: 01/16/2026

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
26
27
28
29
30
31
32

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care
Centers that were constructed before January 1, 2010, to test their water (used for
drinking and food for lead contamination before January 1, 2023, and then every 5 years after the date of the first test. For childcare 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). Or LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600. Review PUB 515 for information and posting.

Facility representative was informed of the MyChildCarePlan.org website, a
consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities,
providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly
Update Newsletters and other important information communication platforms.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: CEDARCREEK STATE PRESCHOOL	FACILITY NUMBER: 197413421
	VISIT DATE: 01/16/2026

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
26
27
28
29
30
31
32

To receive important licensed related information to licensed facilities, visit the CCLD Important
Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/
subscribe and select the Child Care option to receive email communication.

Reminder: The CCLD On Duty Worker is available: Monday through Friday from 8:00 AM - 5:00 PM, at (661) 202-3318 for questions, information, and unusual incident reporting. Once the incident is reported within twenty-four (24) hours via telephone, follow up with a written report (LIC 624 form) via email to unusualincidentreport@dss.ca.gov or via fax (661) 202-3810 within seven days of reporting.

There are no deficiencies cited during this inspection. There was one Technical Violation issued. See LIC 9102 TV page attached to this report.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit (LIC 9213), this report, was given to Guadalupe Grijalva, Facility Representative. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

LIC809 (FAS) - (06/04)

Page: 4 of 7