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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416970
Report Date: 10/27/2025
Date Signed: 10/27/2025 11:23:34 AM

Document Has Been Signed on 10/27/2025 11:23 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:VOA/BUEN PRINCIPO II HEAD START/STATE PRESCHOOLFACILITY NUMBER:
197416970
ADMINISTRATOR/
DIRECTOR:		JESSYCA VEGAFACILITY TYPE:
850
ADDRESS:604 SO. MACLAY AVENUETELEPHONE:
(818) 365-6677
CITY:SAN FERNANDOSTATE: CAZIP CODE:
91340
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 37DATE:
10/27/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Site Supervisor, Erika MendozaTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On Monday, October 27, 2025, at 9:30 am, Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced annual inspection and met with Site Supervisor, Erika Mendoza who guided LPA Garcia on a tour of the facility. This is a preschool program that serves children ages 3 to 5 years. This program operates Monday to Friday 7:45 a.m. – 4:15 p.m. and children attend from 8:15am – 3:15am. Sign in and out takes place at the entrance of each classroom. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. There are 41 children enrolled. Present at the facility were 37 children and 9 teachers providing care and supervision. Site Supervisor, Erika Mendoza informed LPA Garcia that teacher’s personnel files are kept of site at 12502 Van Nuys Blvd, Pacoima. All staff are fingerprinted and cleared.

LPA entered Classroom 01, children were not present in the classroom, they were participating in outdoor play. There were 10 children and 3 teachers. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cubbies for children to store their personal belongings, and disposable cups are used for drinking water as needed. Cleaning supplies were observed to be stored in a key locked metal storage cabinet and inaccessible to the children. LPA Garcia observed a step trash bin with a lid and a sink for hand washing.

LPA entered Classroom 02, and there were 10 children and 2 teachers present in the classroom, the children were observed to be participating in free play. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cubbies for children to store their personal belongings, and disposable cups are used for drinking water as needed. Cleaning supplies were observed to be stored in a metal key locked storage cabinet and inaccessible to the children. LPA Garcia observed a step trash bin with a lid.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2025
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.

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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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA/BUEN PRINCIPO II HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 197416970
VISIT DATE: 10/27/2025
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LPA entered Classroom 03/04, there were a combined total of 17 children, and 4 teachers present participating in free play activities. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cubbies for children to store their personal belongings, and disposable cups are used for drinking water as needed. Cleaning supplies were observed to be stored in a metal key locked storage cabinet and inaccessible to the children. LPA Garcia observed a step trash bin with a lid and a sink for hand washing.

Heating, lighting and ventilation were evaluated by LPA Garcia. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostats located throughout the facility temperature read at 68 - 70 degrees. LPA observed several fire extinguishers located throughout the facility. The valves on fire extinguishers on the required 2A10BC fire extinguishers indicating they were fully charged and serviced on 07/25/25. The smoke detector and carbon monoxide detectors were tested during this visit and LPA heard sounds and are operable. The last emergency drill was conducted on 10/20/25. LPA observed napping equipment (cots) to be in good condition and stored in the classrooms and storage area in the facility. First aid kit supplies are kept inside the classrooms on the walls, in a metal storage container that are inaccessible to the children and some are stored in a bag hanging on high hooks and locked with key and lock and are replenished monthly. LPA observed the kits to be fully equipped. During this visit, per Site supervisor Erika stated there are children who require medication and no children with allergies. The medication is stored in First Aid bag that is locked with a key and lock and kept out of reach of the children. LPA verified the dates on the prescription and is not expired. LPA Garcia asked if there were any poisons, firearms, weapons or bodies of water. Site Supervisor stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Site supervisor Erika stated the ill isolation area takes place in the Site supervisors’ office or FA’s office and children will utilize staff restroom.

The children’s restrooms are located between classroom 01 and classroom 02 and have access on both ends. LPA Garcia observed the restrooms to be in good condition with working toilets, sinks, hand soap dispenser, paper towels. And a sink for hand washing. LPA observed a total of 8 toilets and 6 hand washing sinks. Cleaning supplies in the children’s restroom are kept in a metal storage cabinet mounted on the wall and out of reach to the children. There is a staff restroom at this facility with 1 toilet and 1 hand washing sink.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
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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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA/BUEN PRINCIPO II HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 197416970
VISIT DATE: 10/27/2025
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LPA Garcia entered the outdoor play area. The outdoor play area is enclosed by a large concrete brick property wall that separates the facility from the neighbor’s property. On the left and right sides of the outdoor play area are metal gates measuring more than 5’ high and gates that lead to the parking lot and street have a high hinge lock secured with a key pad lock, making them inaccessible to the children. At the facility LPA observed 2 storage sheds that are locked and inaccessible to the children. They are located on the left and right side of the outdoor areas against the metal gates and are used to store outdoor equipment. LPA Garcia observed the outdoor equipment to be in a safe condition, free of sharp, no loose or pointed parts. The surface of the outdoor activity space (concrete and artificial turf, poured in rubber) is maintained in a safe condition and is free of hazards. LPA Garcia observed play structure and equipment to be age appropriate for ages 3-5 years and areas around or under high climbing equipment, are cushioned with poured in rubber that may absorb a fall. For adequate shade, LPA Garcia observed 2 hip roof shade structures and trees that provide shade. For outdoor water drinking, staff bring out water jugs and disposable cups that and are re-filled as needed. LPA also observed hand washing station for outdoor hand washing.

This program provides breakfast, lunch and pm snack. This facility participates in a food program and the food is prepared in the kitchen, by kitchen staff. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including movable bins with tight-fitting covers that are kept on, and in good repair. Menus were posted in the kitchen and outside for parents and are sent through the digital app, Learning Genie. There are currently no children with allergies. Lead testing was conducted on 8/10/22 and no lead exceedance.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, and Daily Schedule. LPA Garcia observed sign in/out sheets and observed 38 signatures, a child arrived later than the initial head count.

LPA Garcia reviewed the children’s roster, and children’s files. The staff files will be completed at a later time due to them not being located on the premises. Children’s files were observed to be complete.

LPA Garcia observed Site supervisor, Erika Mendoza Pediatric First Aid/CPR certification dated 2/10/24. Site Supervisor has completed the mandated reporter (AB 1207) training dated 11/7/23.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA/BUEN PRINCIPO II HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 197416970
VISIT DATE: 10/27/2025
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Site Supervisor was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com. Preventative Health and Safety certification and proof of immunization against Pertussis, MMR and Influenza declination will be reviewed with teachers personnel files at a later date due to them being kept off location.
Items discussed during this visit:
1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both
2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.
3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
4.LIC 311A - Records to be Maintained at the Facility: LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.
5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.
6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.
7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review
8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination
9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA/BUEN PRINCIPO II HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 197416970
VISIT DATE: 10/27/2025
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Criminal Record Clearance - Site Supervisor 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.
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 21-21.1CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.
For IMS information see PIN 22-02-CCP. 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-carecenters/.
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.

There were no deficiencies during this visit.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted and report was reviewed with Site Supervisor Erika Mendoza.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
LIC809 (FAS) - (06/04)
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