<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191290314
Report Date: 10/09/2026
Date Signed: 10/16/2026 01:52:57 PM

Document Has Been Signed on 10/16/2026 01:52 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:YMCA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191290314
ADMINISTRATOR/
DIRECTOR:		CARRILLO, ROCIOFACILITY TYPE:
850
ADDRESS:1200 NO. MACLAYTELEPHONE:
(818) 365-6881
CITY:SAN FERNANDOSTATE: CAZIP CODE:
91340
CAPACITY: 85TOTAL ENROLLED CHILDREN: 0CENSUS: 53DATE:
10/09/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:37 PM
MET WITH:Rocio Gomez, Site Director TIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 On 10/13/26, Licensing Program Analyst (LPA) Evelyn Garcia amended the Facility Evaluation Report dated 10/09/26, to correct and clarify the documentation regarding the commingling of infant and preschool-aged children and downgrade the citation from a Type A citation to a Type B citation.

On 10/09/26, LPA Evelyn Garcia arrived at the facility to conduct a case management visit. Upon arrival, LPA met with Site Director Rocio Gomez, who provided a tour of the facility. LPA verified a census of 53 children, and 11 teachers present at the facility. All 11 teachers were fingerprinted and cleared.

The Department received information that, on or about 03/07/26, Staff #1 and Staff #2 were providing care and supervision to Child #1, an infant, and Child #2, a preschool-aged child, in the infant outdoor play yard. Based on the information obtained, an infant and a preschool-aged child were commingling.

During the visit, LPA discussed the concern regarding the commingling of children from different age groups with Site Director Rocio Gomez. LPA explained that, pursuant to the applicable California Code of Regulations, Title 22 requirements governing infant care and childcare center operations, the facility must maintain the required separation between children enrolled in the infant program and those enrolled in the preschool program. The facility must ensure that children are cared for and supervised in accordance with the requirements applicable to their respective programs and that staffing arrangements do not result in the commingling of infants and preschool-aged children.

LPA advised the Site Director that appropriate measures must be implemented to prevent the commingling of children enrolled in the infant and preschool programs, including during outdoor activities and transitions between indoor and outdoor areas. The facility must ensure that staff understand and consistently follow procedures for maintaining the required separation between the two age groups while providing appropriate care and supervision.

Based on the information obtained, the facility was cited for a Type B deficiency related to the commingling of infant and preschool-aged children. Please refer to the Facility Evaluation Report (LIC 809-D) for the specific deficiency cited and the applicable regulatory reference.

A copy of the amended Facility Evaluation Report was reviewed with Site Director Rocio Gomez. The report was also emailed to the Site Director for signature, with instructions to return the signed copy to LPA Garcia for inclusion in the facility file. The Site Director was provided with a copy of the report, the Notice of Site Visit, and information regarding appeal rights.
Mariela Ramon
Evelyn Garcia
DATE: 10/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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)
Page: 2 of 3
Document Has Been Signed on 10/16/2026 01:54 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 10/15/2026 09:43 AM


Created By: Evelyn Garcia On 10/09/2026 at 03:59 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: YMCA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191290314

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2026
Section Cited
CCR
101161(A)

1
2
3
4
5
6
7
Limitations on Capacity and Ambulatory Status. The licensee shall not exceed the conditions, limitations and capacity specified in the license.
This requirement was not met, as evidenced by:
1
2
3
4
5
6
7
At the time of visit the toddler children were separated from the preschool children by their designated playground areas. Send plan of correction to CCL by 10/23/26.
8
9
10
11
12
13
14
The Department learned that on or about 03/07/26, Staff #1 and Staff #2 were providing care and supervision to Child #1, an infant, and Child #2, a school-age child, in the outdoor play yard designated for infants, resulting in the commingling of children from different age groups. This poses a potential health and safety risk to children in care.

8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mariela Ramon
NAME OF LICENSING PROGRAM MANAGER:
Evelyn Garcia
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2026


LIC809 (FAS) - (06/04)
Page: 3 of 3