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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364808720
Report Date: 07/25/2025
Date Signed: 07/25/2025 04:03:00 PM

Document Has Been Signed on 07/25/2025 04:03 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:AVUSD RANCHO VERDE STATE PRESCHOOLFACILITY NUMBER:
364808720
ADMINISTRATOR/
DIRECTOR:		MICHELLE PONCEFACILITY TYPE:
850
ADDRESS:14334 PIONEER RD.TELEPHONE:
(760) 247-2052
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
07/25/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Sharon Schneider; Site Supervisor TIME VISIT/
INSPECTION COMPLETED:
04:10 PM
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On Friday, July 25, 2025, at 2:20pm, Licensing Program Analyst (LPA) Hanna Cha and Licensing Program Manager (LPM) Mariela Ramon met with Sharon Schneider; Site Supervisor, to conduct a Case Management inspection related to the relocation of a preschool classroom.

The facility is currently on summer break; therefore, no children were present during the inspection. The preschool program is scheduled to resume on 08/04/2025.

The facility is located at an elementary school. The licensee has requested to relocate the preschool classroom to Room K3. A fire clearance has been approved, authorizing a maximum capacity of 24 preschool children, ages 2.9 to 5 years.

The preschool program operates two daily sessions, Monday through Friday, morning session from 8:15 AM to 11:15 AM and afternoon session from 12:15 PM – 3:15 PM.

LPA and LPM toured, inspected, and measured Room K3 in accordance with the updated facility sketch. The measurements are as follows for Room K3:

Left side width: 26.3 ft- length: 15.5 ft = 407.65

Right side width: 28.5 ft - length: 23.5 ft = 669.75

Teacher desk area (encumbered space): 68 ft

Total square footage minus encumbered space equals 1,009.40 divided by 35 = 28 children

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: AVUSD RANCHO VERDE STATE PRESCHOOL
FACILITY NUMBER: 364808720
VISIT DATE: 07/25/2025
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There is a bathroom located inside room K3 with 1 toilet and 1 sink. There are two additional bathrooms located in room K2 and K1. Each bathroom has 1 toilet and 1 sink. There are a total of 3 toilets and 3 sinks which allows for a capacity of 45 children. The staff use the bathroom located in the teacher workroom area between room K1 and K2.

All fixtures were observed to be age-appropriate, functional, and stocked with soap, toilet paper, and paper towels. Although the indoor space can accommodate up to 28 children, the licensee is requesting capacity for 24 children supporting fire clearance approval.



Classroom K3 was observed to be clean, safe, and well equipped. Furniture and equipment were age-appropriate and in good condition. The room includes a working telephone, and adequate heating, lighting, and ventilation. Cubbies are available for children’s personal belongings, and a variety of age-appropriate toys and learning materials were present.

Drinking water will be provided via a water dispenser with disposable cups. The classroom is also equipped with a functioning smoke detector, carbon monoxide detector, and fire extinguisher. Per Site Supervisor, children do not nap at facility. Cot and mats are provided for use by children in care when needed.

Currently, the facility does not dispense medication. Incidental Medical Services (IMS) policy was discussed, informing Site Supervisor when any IMS is provided, a plan for providing IMS must be submitted to the Department prior to providing care to a child that needs IMS. The plan shall state the type of IMS the facility will be offering, stating the person providing care has been trained to provide the named IMS. The plan will also provide the steps that will be taken when IMS is provided to a child.

The facility currently has two approved waivers on file:

Restroom Waiver: Preschool children use the restrooms located in room K1 and K2. These restrooms provide 2 toilets and 2 sinks designated for TK children and preschool use. Water temperature was tested and found to be within the appropriate range.

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

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
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: AVUSD RANCHO VERDE STATE PRESCHOOL
FACILITY NUMBER: 364808720
VISIT DATE: 07/25/2025
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Play Yard Waiver: Preschoolers share the kindergarten play yard. Outdoor equipment was inspected and found to be in good repair, age-appropriate, and safe for use. The area includes cushioned surfaces beneath climbing structures, concrete space for active play, adequate shaded and rest areas. No bodies of water were observed, and the outdoor area was free from hazards, holes, broken equipment, or debris.

The areas were evaluated based on the California Code of Regulations, Title 22, Division 12.

An exit interview was conducted with Site Supervisor Sharon Schneider, the Notice of Site Visit was issued, and must be posted for 30 days. A copy of this report was read and provided to the facility.

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

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
LIC809 (FAS) - (06/04)
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