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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700076
Report Date: 09/05/2025
Date Signed: 09/05/2025 01:34:43 PM

Document Has Been Signed on 09/05/2025 01:34 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:SERRANO FAMILY CHILD CAREFACILITY NUMBER:
197700076
ADMINISTRATOR/
DIRECTOR:		SERRANO, TOMASAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 809-6722
CITY:NEWHALLSTATE: CAZIP CODE:
91321
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
09/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:01 AM
MET WITH:Tomasa Serrano; LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On Friday, September 5, 2025, Licensing Program Analyst (LPA) Hanna Cha met with licensee Tomasa Serrano. The purpose of the visit was to conduct an unannounced Annual/Random inspection of the facility. LPA disclosed the purpose of the inspection to the licensee. LPA and licensee toured the facility. At time of arrival, Staff #2 (S2) was providing care and supervision to three infants and two preschool-aged children. Licensee arrived approximately 10 minutes after LPA. During the inspection, two additional preschool-children arrived, for a total census of 7 children. The current days and hours of operation are Mondays through Fridays from 6:00 a.m. to 5:30 p.m.

Physical Plant/Indoor/Children’s Area: This is a one-story home with three bedrooms, three bathrooms, attached garage (per licensee, converted with permit), front yard, living room, dining room, kitchen, and back yard. Childcare is provided in the converted garage (ADU) referred to as the childcare area. The children utilize the restroom located in the converted childcare area. The off-limits areas are two restrooms located in main home, bedrooms #1, #2, and #3. LPA observed the childcare entrance gate located at the left of the home which leads to the childcare backyard area. To the right from the childcare entrance gate is the entrance door to the childcare area (ADU). There is a separate entrance gate on the right of the home, not used for childcare. From the childcare entrance door, the door located immediately left leads to the off-limits laundry room. Another door on the other side of the laundry room leads to the main home. The door located across the childcare entrance door leads to the front yard and front door of the main home. At time of inspection, LPA observed the childcare entrance door, laundry room door, and door leading to front yard and front door to remain closed and locked.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2025
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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Document Has Been Signed on 09/05/2025 01:34 PM - It Cannot Be Edited


Created By: Hanna Cha On 09/05/2025 at 12:06 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: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700076

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the in-ground pool and jacuzzi in off-limits backyard area did not comply with Title 22 regulations, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/19/2025
Plan of Correction
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Licensee will provide an approved pool safety cover or alarm that meets ASTM approved standard F 1346-23.Licensee will provide US Coast Guard approved life ring, 12 foot fixed rescue pole, and daily pool inspection documentation. Licensee will reinstall key lockable device to be at least 60 inches from the ground, reinstall gate to be self-closing and self-latching, and vertical clearance from the ground to be no more than two inches, and email proof to LPA Cha by POC due date.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, licensee Mandated Reporter training expired on 11/04/2024 and Staff #2 (S2) Mandated Reporter training expired on 04/21/2023, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/19/2025
Plan of Correction
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Licensee will email proof of completion of Mandated Reporter training for licensee and S2 to LPA Cha by POC due date.
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:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2025


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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700076
VISIT DATE: 09/05/2025
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LPA inspected the indoor/children’s area for safety, cleanliness and good repair. Per LPA observation, there is no fireplace on premises. LPA observed age-appropriate toys and play equipment, a working smoke detector and carbon monoxide detector. LPA observed a fire extinguisher, fully green. There is a designated area for the ill children as necessary.

Bathroom: The childcare bathroom (located in ADU adjacent to door leading to front yard) was observed to be in safe and operating condition. Toilet and faucet are in good operable condition. LPA reminded licensee to keep shampoos, mouthwash, razors, toothpaste, and other hazardous items inaccessible to children.

Kitchen: LPA inspected the kitchen for safety, sanitation, and good repair. Per LPA observation, knives and sharp items are stored in high upper cabinets made inaccessible to children. Licensee participates in the Food Nutrition Program and provides children enrolled with breakfast, lunch, and afternoon snack. LPA reminded Licensee, if food is brought from the child’s home, the container shall be labeled with the child’s name and properly stored or refrigerated.



Outdoor/Children’s Play Area: Children utilize the back yard for outdoor play. The back yard is enclosed by brick wall, metal gate, and wooden gate. LPA inspected for safety, cleanliness, good repair, age-appropriate toys/equipment, and shady areas.

Pools/Spa/Bodies of Water: LPA observed an in-ground swimming pool and jacuzzi in off-limits backyard area. Pool and jacuzzi separated from childcare backyard area by a wooden gate. In addition to the wooden gate, LPA observed ASTM approved mesh fencing measuring at 60 inches from the ground. Gaps or voids of fencing did not exceed four inches in width. The opening of the mesh gate included a key lockable device at 58 inches from the ground. Licensee will make corrections to ensure key lock is raised to at least 60 inches from the ground. The mesh gate swings away from the pool. However, LPA observed the gate does not self-close and self-latch. Licensee will make corrections to ensure that gate self-closes and self- latches. LPA observed vertical clearance from ground to bottom of gate exceeded two inches (approximately 2 ¼ inches).

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700076
VISIT DATE: 09/05/2025
NARRATIVE
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 Licensee will make corrections to ensure that vertical distance from bottom of gate to ground does not exceed two inches. LPA did not observe an ASTM approved pool alarm and/or pool cover, US Coast Guard approved life ring, 12 foot fixed rescue pole, and daily pool inspection documentation. Per licensee statement, licensee was not aware of new swimming pool regulations that came into effect on 01/01/2025. Licensee shall ensure that mesh fencing is locked and closed at all times. Licensee shall ensure that there are no climbing aids near the fence. Licensee shall ensure that the swimming pool fencing will remain in place whenever licensed care is provided. A Type B citation issued. See 809-D.

Other: First aid kit on premises. Per Licensee, there is no smoking in the home. Last disaster drill completed 08/08/2025. Electrical outlets made inaccessible. There is a working telephone (cell phone). Poisons and cleaning products made inaccessible to children (stored in high cabinet in kitchen away from food). Per licensee, there are no weapons/firearms on the premises.

File Review: LPA review two children which included all required documentation.


LPA reviewed licensee’s file and Staff #2 (S2) file. Per interview and record review, Licensee’s Pediatric CPR/FA expired on 05/2025. At time of inspection, licensee was enrolled in CPR/FA course. S2 who was present with licensee providing care and supervision, had current Pediatric CPR/FA documentation on file. A Technical Violation issued.

Per record review, licensee Mandated Reporter training expired on 11/04/2024. Staff #2 (S2) Mandated Reporter training expired on 04/21/2023. LPA informed licensee that Mandated Reporter training for all personnel must be renewed every two years. A Type B citation issued. See 809-D.

Postings: Notice of Parent's Rights Poster (PUB 394), Facility License (LIC 203), Emergency Disaster Plan (LIC 610A)

Documents Provided: Entrance Checklist, Capacity Chart
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700076
VISIT DATE: 09/05/2025
NARRATIVE
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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.

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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations. Also, to enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report (LIC624B) when submitting a report to the department at: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven (7) days following the occurrence of any events specified above.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700076
VISIT DATE: 09/05/2025
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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 purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, licensee Tomasa Serrano confirmed that there are no Registered Sex Offenders residing in the facility.

During this inspection, one Technical Violation issued and two Type B citations issued. See 809-D.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with licensee Tomasa Serrano, along with Appeal Rights.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025
LIC809 (FAS) - (06/04)
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