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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 267750002
Report Date: 08/27/2025
Date Signed: 08/27/2025 04:39:34 PM

Document Has Been Signed on 08/27/2025 04:39 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:MAMMOTH INCLUSIVE PRESCHOOLFACILITY NUMBER:
267750002
ADMINISTRATOR/
DIRECTOR:		TAMMY NGUYENFACILITY TYPE:
850
ADDRESS:1500 MERIDIAN BLVD.TELEPHONE:
(760) 934-7545
CITY:MAMMOTH LAKESSTATE: CAZIP CODE:
93546
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 6DATE:
08/27/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:02 PM
MET WITH:Jackie Ramirez, Lead TeacherTIME VISIT/
INSPECTION COMPLETED:
04:37 PM
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On August 27, 2025, at 2:02 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with the Lead Teacher, Jackie Ramirez, to conduct an unannounced annual inspection for the Preschool license in accordance with the facility sketch. The preschool component is located on the grounds of Mammoth Elementary School in building J/Classroom #3. A tour of the facility was conducted. LPA observed eight children inside the classroom with three staff providing care and supervision. The hours of operation are Monday to Friday, from 8:00 A.M. to 4:00 P.M. Incidental Medical Services (IMS) was discussed. Licensing fees are due on September 8, 2025, amounting to $242.00

Indoor/Children’s Area:
Child care center is clean, safe, sanitary and in good repair; floors of all rooms have a surface that is safe and clean, cleaning compounds are inaccessible, poisons are locked, furniture/equipment is in good condition. Indoor activity space for children is equipped with age-appropriate furniture and equipment including tables, chairs, and cubbies to meet children’s needs; Per Lead Teacher Ramirez, tables, chairs, and toys are sanitized every day and whenever needed. All play equipment and materials used by children are age-appropriate, each child has an individual or portable storage space (cubby, individually labelled with name) for his/her clothing and personal belongings. The facility has a working telephone.

Trash bins have tight fitting lids. Soiled and wet diapers are placed inside trash bins with lids located inside the bathroom. Children bring their own bottled water. All materials and surfaces are toxic free and are inaccessible. There is no fireplace in the facility. The center has an internal pull-down fire alarm system, and it has a 2-A:10-B:C type of fire extinguisher. Carbon monoxide devices are in operable condition (tested at 2:32 P.M.).
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2025
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.

LIC809 (FAS) - (09/23)
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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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/27/2025
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Restrooms: LPA inspected and observed a total of 1 toilet and 1 sink in the bathroom. Staff members have a separate restroom to use. The LPA also observed liquid soap, toilet paper, trash bins with covers, and paper towels inside the bathroom. Water temperature is appropriate.



There is an isolation area in the corner of the room (book area) and parents are called to pick up their children. Once the child is picked, the area will be sanitize. The facility maintains a comfortable temperature at all times, first aid supplies, electronic sign in/out sheets are available and completed daily. Smoking is prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Napping: LPA observed sleeping cots for napping. Per Lead Teacher Ramirez, parents provide sheets to their children in care for nap time and the sheets are washed during Fridays. Sleeping mats are wiped/cleaned/sanitized, or when soiled and there is no contact with other children bedding.

Outdoor: The facility has a playground area for preschoolers. Per Lead Teacher Ramirez, children used the outdoor playground in the morning between 10:30 A.M. to 11:15 A.M., depending on the weather. Children bring their own bottled water. The facility used carts to bring the bottled water, childrens’ files, first aid kit, and other emergency supplies.

Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. LPA observed a retractable canopy at the outdoor playground. The area was observed to be free of debris, free from hazard, holes, broken items, debris. The area where infants play is made up of sand and turf. The small slides are situated on the turf to absorb the fall. No bodies of water were observed.

Teacher child ratios were observed, and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.



Health Related Services: According to Lead Teacher Ramirez, they were providing medications to just one child. Per Lead Teacher Ramirez, she and Danielle Dublino, the Special Education teacher, were trained to administer medications.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/27/2025
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Children are inspected for illnesses (wellness policy) as they arrive. Per Lead Teacher Ramirez, children were physically observed when they arrived at the center.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Food Service: There is a clean microwave, refrigerators, and freezers available in the facility. Per Lead Teacher Ramirez, the morning snacks are provided at 10:30 A.M. and afternoon snacks are provided at 2:30 P.M.

Staff/Personnel Records: Director (qualified) qualifications were verified, Designation of Responsibility observed, immunization's, TB clearance for staff, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file. Staff #3 do not have CPR and First Aid training. Per Lead Teacher Ramirez, staff #3 will take the CPR and First Aid training.

Facility Records: Roster, fire/disaster drills log was last completed on August 25, 2025, at 9:40 A.M. Per children’s records review, child #1 do not have LIC 3221 Parent Consent for the Administration of Medications. The Lead Teacher was advised to have the parent fill out the form and include it in the child’s file.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393), PUB 269 Child Passenger Restraint System Poster, emergency disaster plan, and earthquake preparedness checklist.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/27/2025
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Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.

Advisory/Other: First Aid kit was observed with supplies readily available. The thermometer is kept separately from the first aid kit.

Sign in and out sheets were reviewed. The facility uses electronic sign in and out sheets and were recorded daily. The parent board was reviewed and has all the required forms posted.

Director was advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: 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 a day care center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.



The director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/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. Director shall permit the Department to inspect the day care center, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: MAMMOTH INCLUSIVE PRESCHOOL
FACILITY NUMBER: 267750002
VISIT DATE: 08/27/2025
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www.cdss.ca.gov/inforesources/community-care-licensing/process

No deficiencies were cited during this inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8:00 A.M. to 5:00 P.M.



Exit interview conducted and a copy of this report, Notice of Site Visit, and appeal rights were provided to Lead Teacher, Jackie Ramirez.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC809 (FAS) - (06/04)
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