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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830628
Report Date: 12/02/2025
Date Signed: 12/02/2025 04:17:12 PM

Document Has Been Signed on 12/02/2025 04:17 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:OCS HOLY ROSARY ACADEMY PRESCHOOLFACILITY NUMBER:
364830628
ADMINISTRATOR/
DIRECTOR:		AUSTIN, CHERYLLFACILITY TYPE:
850
ADDRESS:2620 N. ARROWHEAD AVENUETELEPHONE:
(909) 886-1088
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 44TOTAL ENROLLED CHILDREN: 18CENSUS: 14DATE:
12/02/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Facility Representative Enedina Mendiola TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On December 2, 2025, at 11:45am, Licensing Program Analyst (LPA) Kendal Zirbes met with Facility Representative Enedina Mendiola. The purpose of the inspection was to conduct the Annual/Random inspection, at the licensed facility. LPA disclosed the purpose of the inspection to the Facility Representative. Present during today’s inspection were 14 preschool age children, two teachers and support staff. The preschool program is operated out of two classroom (Cubs and Explorers) on OCS Holy Rosary Academy. The facility operates 7:00a.m. to 6:00 p.m, Monday to Friday. The Center has two approved waivers on file regarding the outdoor space and the restrooms.
Indoor/Children's Area: Child care center was observed to be clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were stored in the classrooms and cabinets equipped with locks/latches which made the cleaning products inaccessible to the children in care. Zero poisons are stored in the classroom. LPA observed the furniture/equipment is in good condition. Classroom was free of flies, other insects, rodents. The classroom had tables and chairs to meet children’s needs. LPA observed the classroom had areas for dramatic play, art, writing, manipulates, and a library. Children's belongings are kept in cubbies labeled with the children's names. Trash cans for solid waste have tight fitting lids. Drinking water is readily available indoors via personal water bottles labeled with the child's name. All materials and surfaces are toxic free, window screens in good repair and free of debris. Each classroom was equipped with a carbon monoxide detector. The detectors were tested during this inspection and were found to be in working order. .
Restroom: An approved waiver is on file regarding the bathroom. The preschool students utilize the elementary girls bathroom. The bathroom was equipped with five toilets and five sinks. Bathrooms were observed to be in safe and sanitary operating condition. Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628
VISIT DATE: 12/02/2025
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Report continued from page one
Restroom continued: Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available.
There was working telephone service in the Center. There is an isolation area for children who become ill. The isolation area is located within the administrative office located in the main office of the school. The facility maintains a comfortable temperature at all times. LPA observed the centers electronic sign in/out sheets, which are completed daily. Smoking is prohibited on the premises. LPA did not observe prohibited childcare items during this inspection.
Firearms/weapons are not allowed or stored on premises. LPA did not observe bodies of water on the premises. Facility representative stated there are zero bodies of water or weapons stored in the property. Meals are provided by the families and two snacks are provided by the school.
Napping
LPA observed the children napping during this inspection. The children were napping on individual cots.
Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The area has one large play structure, and swings. There was cushioning material under the climbing structure and swings. The swings and climbing structure were securely anchored to the ground. The area was observed to be free of debris at the time of this inspection. Drinking water is readily available for the children when outdoors via personal water bottles. An approved waiver was on file regarding the outdoor space.
Child/Personnel Records
LPA reviewed six child records and two personnel files during this inspection. Based on LPA record review, one of six child files reviewed (Child 2 (C2)) did not have a written medical assessment on file. C2 enrollment date was 08/20/2025. Per interview with facility representative the family has been having a hard time obtaining an appointment for the medical assessment. The Center has reminded the family of the need to obtain a medical assessment, as soon as possible. A technical advisory notice was issued regarding the medical assessment. Furthermore, based on LPA review, C2 file did not contain immunization paperwork or the CDPH 286. LPA spoke with facility representative Salena and Enedina who confirmed immunizations records were not within C2 record. The Center was unable to provide the immunizations records during this inspection. Report continued on page three
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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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: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628
VISIT DATE: 12/02/2025
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Report continued from page two
Child/Personnel Records (continued): Staff reported C2 transferred from the kindergarten class to the preschool in August and this may have lead to the missing documents. A type B citation was issued, for regulation 101220.1(a), refer to LIC 809D. Per LPA record review, staff 1 (S1) records did not contain a health screening with a tb test. S1s Date of hire was 08/2023. LPA spoke with S1 about the health screening. S1 stated they had not completed a health screening prior to employment and stated they had an appointment scheduled for 12/8/25. The Center was issued an advisory notice on 11/21/2024 regarding the requirements for staff to obtain health screening. A type B citation was issued for regulation 101216(g)(1), refer to LIC 809D. During the inspection, LPA was informed by facility representative Mendiola that one child (Child 1 (C1) receives IMS at the Center. LPA reviewed C1's prescription medication. C1s prescription medication was not labeled with C1 name as required. Facility representative Mendiola expressed C1 has been provided with the prescription medication one time while in care. LPA and facility representative Mendiola discussed IMS. HSC, Section 1596.798 was provided to the facility. A type B citation was issued for regulation, 101226(e)(2), refer to LIC 809D.

Facility representative 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 as specified in Health and Safety Code section 1597.16. 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 21-21.1-CCP.). LPA verified that the lead testing was completed in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP.
LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES.
Report continued on page four
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628
VISIT DATE: 12/02/2025
NARRATIVE
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Report continued from page three
LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for and removing any 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.
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-care-centers/.

Facility representative 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.

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.
Based on LPA record review and interviews, three type B citations, one technical assistance and one technical notice were issued.

A notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report was reviewed with the facility representative Enedina Mendiola.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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Document Has Been Signed on 12/02/2025 04:17 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 12/02/2025 at 02:33 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: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in one out of two staff files did not contain a health screening which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/16/2025
Plan of Correction
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Per facility representative, S1 has an appointment for the health screening on 12.8.25. A copy of the health screening will be submitted to the Department. The Center will ensure all employees received a health screening including a test for tuberculosis not more than one year prior or seven days after employment.
Type B
Section Cited
CCR
101220.1(a)
Immunizations
(a) Prior to admission to a child care center, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, commencing with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in one out of six child files did not have documentation of their immunizations prior to admission which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/08/2025
Plan of Correction
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Per facility representative, Child 2 immunization record will be obtained from the authorized representative by 12/4/25. The Center will complete the CDPH 286 by 12/5/25. A copy of the records will be submitted to the Department by 12/8/25. Center will ensure all child files contain documentation of the children immunization's prior to admission.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2025


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Document Has Been Signed on 12/02/2025 04:17 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 12/02/2025 at 02:33 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: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(2)
Health-Related Services
(2) All prescription and nonprescription medications shall be maintained with the child's name and shall be dated.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in when a prescription medication was not maintained with the child's name as required, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/03/2025
Plan of Correction
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Per facility representative, prescription medications will be reviewed and the Center will ensure all medications are labeled with the child's name. The Center will submit a written statement to the Department declaring all medications have been reviewed and are labeled.
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.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2025


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