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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700636
Report Date: 03/12/2025
Date Signed: 03/12/2025 12:32:01 PM

Document Has Been Signed on 03/12/2025 12:32 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:ERDENBILEG FAMILY CHILD CAREFACILITY NUMBER:
197700636
ADMINISTRATOR/
DIRECTOR:		SHINEE ERDENBILEGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 572-7317
CITY:STEVENSON RANCHSTATE: CAZIP CODE:
91381
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/12/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:53 AM
MET WITH:Shinee ErdenbilegTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On March 12, 2025, Licensing Program Analyst (LPA) Calloway made an unannounced inspection to the above facility. LPA met with Licensee, who granted access. LPA and Licensee toured the home inside and outside for an Annual Random inspection. Residing in the home are the Licensee, spouse, and two minor children. The home is licensed for twelve to fourteen children. LPA observed twelve (12) day care children in active care with licensee and representative during inspection ages one - five years old. Daycare hours are 8:00 AM -5:00 PM. Monday through Friday. All adults working and residing inside the home have a criminal record clearance and are associated to the facility.
Physical Plant: This is a two story three-bedroom, two-bathroom home with kitchen, dining area, family room, living room, laundry room, and garage. Childcare is provided: in the Living Room and Family Room upon entry. Children’s Bathroom: is on the right upon it was observed to be clean, with soap, toilet paper, paper towels, functioning sink and toilet and there were no hazards. The unused outlets in the home were covered. There were louver shades at the windows and laminate flooring. LPA observed age-appropriate toys, furniture, and books in good repair. There was napping equipment in the form of mats and there is enough for all children in care. The home was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, hazardous conditions. The detergents and cleaning compounds are kept inside the kitchen underneath the sink with a safety latch. The medicines are kept in off limits bathroom upstairs. The windows are screened, free of bugs, cracks, and debris.Fire and disaster drills were reviewed; Fire drill was last conducted: 2/25 and the disaster drill for earthquake was not conducted. Per Licensee, they were not aware the other drill needed to be conducted. The fire extinguisher (2A10BC) was full, and needle was inside the green area and last inspected 3/12/25. The smoke and carbon monoxide detectors were tested as operable. The fireplace is inside the family room observed screened with a glass covering.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636
VISIT DATE: 03/12/2025
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The home has central air conditioning and heat. The required postings were present on the parent wall. There is no landline phone, but cell phone. The stairs were gated. The fire alarm pull switch was observed on the wall near the back door. There was a single action door handle. Exit signs were posted over the doors leading outside.
Kitchen: Inside the Kitchen, the items that can pose a danger to children were made inaccessible with safety latches. LPA observed a Cuinsart knife block set with several sharp knives on the counter to the right of the sink. The counter is open and next to the area where the children play and a stool on the other side of the counter gave access to the children of the knives. They were removed to a cabinet on a shelf during the inspection.
Off limit areas: Upstairs: Bedrooms: #1, #2, #3, Bathrooms: #2, Bathroom #3 upstairs, laundry, and garage.
Outside: The backyard is completely fenced, and the fencing material is iron and block wall and in good repair. Per Licensee, there are pets in the home. LPA observed one small dog inside the home. Per Licensee, the pet is vaccinated and does interact with the day care children. There are toys, bikes, and play equipment. Per Licensee, there is no body of water on premises. LPA did not observe an in-ground pool, spa, or body of water on the premises. There is a shaded rest area with tables and chairs and artificial turf and concrete for play. The air conditioning (AC) unit in the yard was observed uncovered. There was a storage shed unlocked. Per Licensee, the neighbor on their right has a pool there is a block wall in between at least 6 ft high.
Others: Per Licensee, there are no weapons or firearms on the premises. LPA did not observe any in the home. The mandated reporter training was viewed. CPR/First Aid (Exp: 2/2026), and immunizations were viewed. The First Aid kit was observed with supplies. The Child/Parent roster was complete with all required information, but one page of the roster was missing. LPA viewed staff and children’s files and some of the kids’ files were missing required forms. Per licensee, files were moved to a different location due to a recent fire in the area and have not been brought back to the facility. . LPA conducted a staff interview with the licensee. Per Licensee, transportation is not provided. Incidental Medical Services (IMS) policy and Safe Sleep regulations were discussed. Per Licensee, the home does not have daycare liability insurance.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636
VISIT DATE: 03/12/2025
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The following was discussed with the Licensee:
Maintain capacity and transparency per posted parent rights, Roster requirements (keep updated information always and maintain information for three years), Documentation for disaster drills (fire and earthquake). Mandatory forms, signed, for the children’s/staff files, know updated Safe Sleep regulations. The role and responsibilities of being a mandated reporter. Supervision is always required for children in care. If food is brought in, it is properly labeled. Check food expiration dates periodically. Responsible for knowing the regulations as well as anyone who assists in providing care. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. If day care is closed for an extended period, must notify Licensing. Inaccessibility of hazards must be constantly reassessed depending on the children in care. If the phone number is changed, licensing must be notified. Regulations prohibit the smoking of tobacco in a private residence that is licensed as a family childcare home and areas of the day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exer saucers, bassinettes, and any other items that fall into that category.

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 Childcare 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.


Type A deficiency: Type A deficiency shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is an immediate risk to the health, safety, or personal rights of children in care. Licensee shall provide a copy any Type A deficiency to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of the Type A report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) must be placed in the child's file for verification of the Type A deficiency.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636
VISIT DATE: 03/12/2025
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Failure to do so will result in a civil penalty being assessed.
--Licensee is advised to visit: www.shotsforschool.org for Immunization information.
--Licensee was informed of their responsibility to report suspected Child Abuse (LIC 9108), 1-800-827-8724/760-243-6640. Licensee was informed of the MyChildCarePlan.org website, a
consumer education website that helps families obtain childcare by connecting them to child
care providers and Resource and Referral Agencies (R&Rs) throughout California.
--Family Child Care Providers (Disaster Planning information):
https://cccld.childcarevideos.org/family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Child Care Videos: https://ccld.childcarevideos.org
--Licensee advised to visit the CCLD website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.
--Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department prior to providing the IMS. 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: http://www.ada.gov/childqanda.htm.
--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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636
VISIT DATE: 03/12/2025
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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.
--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.

Reminder: The On- Duty Worker is available for questions at: (661) 202-3318 (Monday-Friday 8am-5pm) and for reporting Unusual Incident Reports (within 24 hours). Written Unusual Incident Reports are sent (using (LIC 624 form) to the following email address: unusualincidentreport@dss.ca.gov within seven (7) days after reporting the incident via telephone.

There are deficiencies cited during this inspection and a Technical Violations. See 809D pages and TV pages attached to this report.

An exit interview was conducted, a copy of this report was read, and a Notice of Site Visit, Appeal Rights, were provided to Shinee Erdenbileg, Licensee during the inspection. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain the posting will result in $100 civil penalty. During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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Document Has Been Signed on 03/12/2025 12:32 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 03/12/2025 at 12:13 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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (A) Storage areas for poisons, firearms and other dangerous weapons shall be locked.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview the licensee did not comply with the section cited above in there wre knives on the counter that were accessible to the children with a climbing stool and were removed during the inspection which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/19/2025
Plan of Correction
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I will always keep the knives in the upper cabinet
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in C5, C6, and C8 did not have immunizations in their files during inspection which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/26/2025
Plan of Correction
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I will provide proof by POC 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.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/12/2025 12:32 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 03/12/2025 at 12:13 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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in C1, C2, C3, C5, and C9 were not observed on the facility roster during inspection which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/26/2025
Plan of Correction
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I will complete the roster by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2025


LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 03/12/2025 12:32 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 03/12/2025 at 12:13 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: ERDENBILEG FAMILY CHILD CARE
FACILITY NUMBER: 197700636

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in C1, C4, C8, and C9 did not have files for review at the facility and were missing LIC 995A form which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/26/2025
Plan of Correction
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2
3
4
I will have the parent's sign and complete all required forms and provide proof by POC 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.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2025


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