191201899-3-18-2022-12-CC-CBEL-CD6TPP-20220404145436

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191201899
Report Date: 03/18/2022
Date Signed: 03/18/2022 03:23:02 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
01/11/2022 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20220111124442

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: 30	DATE:	03/18/2022
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Tammy Damon		TIME COMPLETED:	03:35 PM

ALLEGATION(S):

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Allegation 1: Facility has a gas leak
Alegation 2: Facility is out of ratio
Allegation 3: Staff are not properly disinfecting the facility

INVESTIGATION FINDINGS:

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On March 18, 2022 at 9:32AM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection on the above allegations. LPA disclosed the purpose of inspection and was granted entry by Director, Tammy Damon, who guided LPA on a tour of the facility. Upon entry, LPA observed 30 preschool children in care with 8 staff at the facility, verified on association list.

During the course of the investigation, LPA conducted interviews with staff, parents, children, and obtained facility records. On 12/21/21, the fan in the wall heater located in the Pre-K room was replaced by Heating Company 1 (B1) because the heater was not functioning properly. On 12/23/21, facility staff observed an odor of gas in the Pre-K Classroom and notified Director. The gas company was contacted to inspect and determined the heater in the Pre-K room has a minor leak in need of repair. On 12/24/21, the Plumbing Company 1 (B2) was contacted and arrived to the facility on 12/30/21. B2 replaced the valves in the bottom compartment of the heater. On 01/03/22, the smell of gas returned and the Director was notified.

Unsubstantiated

Estimated Days of Completion: 67

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

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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Control Number 12-CC-20220111124442

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: LANCASTER UNITED METHODIST CHURCH PRE SCHOOL	FACILITY NUMBER: 191201899
	VISIT DATE: 03/18/2022

NARRATIVE

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B1 found and tightened a loose low voltage wire on the gas valve. Prior to leaving, B1 determined wall heater was operational. No further odors of gas have occurred since 01/03/22.

LPA created a spreadsheet to compare teacher schedules according to time card and child sign in sheets. LPA also conducted staff interviews. Based on evidence gathered, it was determined the facility was within ratio.

Based on staff and child interviews, facility staff disinfect the classrooms throughout the day and conduct a deep clean during nap time after lunch. Children participate in cleaning in the Pre-K room utilizing damp paper towels or baby wipes. Staff follow behind children with a disinfectant wipe to thoroughly disinfect tables. Staff clean toys as needed throughout the day. The Cleaning Company 1 (B3) comes to the facility daily to disinfect the center to conduct a deep clean. Additionally, as as safety precaution, Director made the determination to close the facility to children as a COVID-19 safety precaution and required staff to deep clean the facility. LPA provided consultation to Director to notify Department of closures outside normally scheduled closures as identified on the plan of operation. Director provided scheduled closures during inspection.

Based on evidence obtained and interviews conducted, the above allegations are deemed Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations did or did not occur. No violations cited during inspection.

An exit interview was conducted, this Report, Appeal Rights, and Notice of Site Visit were provided to Director, Tammy Damon.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

LIC9099 (FAS) - (06/04)

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