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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700331
Report Date: 01/23/2026
Date Signed: 01/23/2026 11:35:23 AM

Document Has Been Signed on 01/23/2026 11:35 AM - 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:CORNEJO FAMILY CHILD CAREFACILITY NUMBER:
367700331
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
01/23/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:ALBA CORNEJO- LICENSEETIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On Friday January 23, 2026, Licensing Program Analyst (LPA) Giovanni Cristales conducted an announced visit with Licensee Alba Cornejo who guided the analyst on a tour of the home for an Annual/Random and Change of Capacity increase inspection for a large family childcare home, twelve to fourteen children. LPA toured the areas of the home utilized for the Family Child Care to ensure the home follows Community Care Licensing Title 22 Regulations. Present during the time of this inspection are Licensee, assistant and two children in care. Family members residing in the home include three adults (Licensee, licensee spouse, licensee dad) and three children. Days/hours of operation are Monday through Friday 6:00 am to 6:00 pm. There is no pool/or body of water on the premises. LPA did not observe any pool or body of water on the premises.

Physical Plant: This is a one-story home with 3-bedrooms, 2-bathrooms, living room, kitchen, dining area, laundry/garage, enclosed patio, front and backyard. The living room is utilized for Family Child Care (upon entry), bathroom #1 (hallway to the left), dining area and backyard. The home was inspected for safety, comfort, cleanliness, telephone service, and proper ventilation. There is a working telephone (cell). LPA observed age-appropriate furniture for the children that is in good repair. There are toys and books on the premises of this facility. LPA observed appropriate napping equipment, cots and playpen. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris. The blinds are cordless (Twist handle). The fireplace was observed in the living room and is covered with cubby shelving in front. There is a hallway closet locked (key lock) for storage supplies and medicines. All unused electrical outlets are covered with plastic plugs. The isolation area is a small child sofa near the dining area until the parent can pick up the child.

Bathroom: The Bathroom (in the hallway on the left) was toured and inspected. Clean, sanitized, and in good repair with sink/toilet in operable condition. There were no shampoos, mouthwash, razors, poisons, or medications. LPA observed shower to be completely empty. The cabinets and drawers were locked with a magnetic lock.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2026
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: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 367700331
VISIT DATE: 01/23/2026
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Kitchen : Inspected there were no hazardous or dangerous items. All the sharp utensils and knives were stored inside the kitchen cabinet to the left of the stove up high. The refrigerator/ freezer was inspected, and both were clean and in good repair. Dining seating for at least six children was observed. Detergents/cleaning compounds are kept in the off-limits laundry/garage. Cleaning chemicals were observed underneath the sink and made inaccessible to children with a magnetic lock. Per licensee she participates in the food program providing breakfast, morning snack, lunch, afternoon snack, and dinner.

Off-limit areas: Include all the home’s bedrooms #1- #3, bathroom #2, kitchen (metal gate), garage, and laundry room. The laundry/garage room is made inaccessible by a doorknob cover, LPA observed key locks on door to Bedroom #3 and safety doorknobs on Bedroom #1 and Bedroom #2.

Outdoor: Access through garage. There is an enclosed patio before entering backyard. The backyard was inspected. The backyard is fenced all around with chain link fence. There is grass, concrete, and mulch areas for active play. There is a swing and slide set that is anchored to the ground. There are two play structures, one anchored to the ground (ladder redirected), and one Little Tikes which can be moved. There are age-appropriate toys and bikes for playing. LPA observed three small pet dogs, chickens and ducks in the backyard (gated, separate area). The dogs are vaccinated and per Licensee the animals do not interact with the day care children. LPA observed two storage sheds also in the gated area of the backyard. A separate storage shed located in the children’s playing yard, made inaccessible with pad lock. LPA observed one grill made inaccessible with cover, and the AC/Heating Unit is on the right side of the home in the front yard.

Advisory/Other: First Aid kit was observed to be full of supplies readily available (scissors/ tweezers), located in the hallway closet to the left. CPR/First Aid, Expires: (4/12/2027), Mandated reporter, Expires (2/4/2027). No recalled and prohibited toys or sleep/ play equipment were observed on the premises. LPA observed the required fire extinguisher (3A10BC) in the kitchen cabinet being fully charged with the needle in the green. Per licensee there are no weapons/firearms in the home. Per licensee nobody smokes in the home.

LPA observed documents to be posted in a prominent, publicly accessible area (outside of home); (License, PUB 394, Earthquake Preparedness, facility sketch, Emergency Disaster Plan and verification of fire and earthquake drills, (9/12/25) to be complete and current. LPA reviewed 2 children’s files, and three staff files. All files were complete. LPA observed sleep logs to be current. Per licensee, transportation is being provided currently.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
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: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 367700331
VISIT DATE: 01/23/2026
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The following was discussed with the Licensee:

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters, and other important information communication platforms.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Licensee was reminded that 100% supervision is required at all times to children in care; Licensee was made aware that it is her/their responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care.

Licensee was advised of the requirement to report Unusual Incidents. 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 days following the occurrence of any events specified above. Licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (unusualincidentreport@dss.ca.gov).

Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changes, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "childcare" room; Room additions to the family childcare home.

Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

Criminal Record Clearance- FCCH - 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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
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: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 367700331
VISIT DATE: 01/23/2026
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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.

Safe Sleep – FCCH - 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-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. 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/. Per licensee, IMS is not being provided currently.

MyChildCarePlan.org – FCCH - 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.

Megan’s Law - FCCH - On this date, 1/22/2026, the California Attorney General - Megan’s Law website was verified for information on sex offenders which required to register with local law enforcement under California's Megan's Law. During the exit interview, the Licensee , Miriam Najera confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
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: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 367700331
VISIT DATE: 01/23/2026
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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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The director 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 childcare 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.

On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8 am-5 pm.

No Deficiencies in today’s visit. Home is ready for capacity increase. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, and report was reviewed with the licensee Alba Cornejo.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Giovanni Cristales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
LIC809 (FAS) - (06/04)
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