191201899-11-16-2021-12-CC-CYAS-C8W3JE-20211118171725

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191201899
Report Date: 11/16/2021
Date Signed: 11/16/2021 03:07:17 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/20/2021 and conducted by Evaluator Justin Dorsey

COMPLAINT CONTROL NUMBER: 12-CC-20210820144130

FACILITY NAME:	LANCASTER UNITED METHODIST CHURCH PRE SCHOOL		FACILITY NUMBER:	191201899
ADMINISTRATOR:	DAMON, TAMMY		FACILITY TYPE:	850
ADDRESS:	918 WEST AVENUE J		TELEPHONE:	(661) 942-0812
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	58	CENSUS: 27	DATE:	11/16/2021
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Tammy Damon		TIME COMPLETED:	03:23 PM

ALLEGATION(S):

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Staff are not following COVID-19 mask guidance.
Staff did not inform parents of COVID-19 cases and exposure.

INVESTIGATION FINDINGS:

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On 11/16/21 Licensing Program Analysts (LPA) Dorsey conducted a complaint investigation at the facility to deliver complaint investigation findings. LPA met with director, who guided LPA on a tour of the facility. Upon arrival LPA observed 27 children in care with 4 staff. All staff are fingerprint cleared and associated to the facility.
The investigation consisted of interviews with the director, staff, children and a parent of the program. LPA observed all staff and children wearing face coverings during the 10-day visit on 08/24/2021 as well as the follow up visit today (11/16/21). Based on the evidence obtained and LPA observation the above allegation is deemed unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the facility is not providing a safe and healthful environment, Therefore the above allegations are Unsubstantiated. A technical advisory will be given to the facility today 11/16/2021 as LPA advised Director on the importance of mask wearing.
An exit interview was conducted, and a copy of this report was provided to Director Tammy Damon along with Notice of Site Visit and Appeal Rights.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 11/16/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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