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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191228064
Report Date: 11/12/2020
Date Signed: 11/12/2020 11:43:12 AM



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
09/30/2020 and conducted by Evaluator Monique Jessica Ayala
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20200930165122
FACILITY NAME:DAVIDSON FAMILY DAY CAREFACILITY NUMBER:
191228064
ADMINISTRATOR:DAVIDSON, SHERRIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 251-3695
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY:14CENSUS: 6DATE:
11/12/2020
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sherri Davidson, LicenseeTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Personal Rights: Provider hit day-care child
INVESTIGATION FINDINGS:
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On 11/12/2020 Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced complaint investigation for the above allegation. At 10:30am, LPA was greeted by licensee. LPA toured the facility and gathered the census of children present. There were 6 preschool age children in care with the supervision of the licensee and her assistant.

The investigation consisted of interviews conducted with Licensee, Licensee’s staff, children, and other relevant complaint parties. The interviews revealed that there were no witnesses that could corroborate that the provider hit a day-care child. Licensee and staff at the facility denied that hitting is permitted in the facility as a form of discipline. LPA spoke with licensee and assistants about discipline policy, which is to verbally redirect children.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 12-CC-20200930165122
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: DAVIDSON FAMILY DAY CARE
FACILITY NUMBER: 191228064
VISIT DATE: 11/12/2020
NARRATIVE
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Based on information provided, the above allegation is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged occurred.

There are no deficiencies cited at this time.

An exit interview was conducted a copy of this report was provided to the licensee along with Appeal rights and a Notice of Site visit.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2