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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364820249
Report Date: 05/08/2019
Date Signed: 05/08/2019 03:04:30 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/14/2019 and conducted by Evaluator Linda Thompson-Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20190314135748
FACILITY NAME:SHIPMAN FAMILY CHILD CAREFACILITY NUMBER:
364820249
ADMINISTRATOR:JACQUELINE SHIPMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 949-8394
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:14CENSUS: 10DATE:
05/08/2019
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Jacqueline ShipmanTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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9
Allegation #1: Personal Rights - Daycare staff spank the children.
INVESTIGATION FINDINGS:
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LPA Thompson-Miller conducted an unannounced complaint inspection for the purpose of delivering finding for the above allegation. Upon arrival LPA observed 10 children (5 school age, 5 preschool/toddler) in care along with licensee spouse (assistant). LPA met with Licensee, Jacqueline Shipman.

Although it can't be determined that Licensee or other staff spank daycare children, it is determined that Licensee used an inappropriate form of discipline (use of the hand), none of the children felt humiliated or pain inflicted. Based on interviews conducted with staff, parents and children the above allegation is Substantiated. LIC9099D issued.

Exit interview conducted, report was read and provided to Licensee, Jacqueline Shipman.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
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 4
Control Number 12-CC-20190314135748
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: SHIPMAN FAMILY CHILD CARE
FACILITY NUMBER: 364820249
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/15/2019
Section Cited
CCR
102423(a)(4)
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(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not
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Licensee shall ensure to use discipline that is appropriate and submit statement to Community Care Licensing by due date of the discipline used at the FCCH.
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limited to, the following:(a)(4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature. This requirement was not met as evidenced by:Licensee used hand as a form of discipline.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/14/2019 and conducted by Evaluator Linda Thompson-Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20190314135748

FACILITY NAME:SHIPMAN FAMILY CHILD CAREFACILITY NUMBER:
364820249
ADMINISTRATOR:JACQUELINE SHIPMANFACILITY TYPE:
810
ADDRESS:13985 LIVE OAK STREETTELEPHONE:
(760) 949-8394
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:14CENSUS: 10DATE:
05/08/2019
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Jacqueline ShipmanTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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9
Allegation #2: Personal Rights: Daycare staff pull the daycare child's ears.
Allegation #3: Personal Rights: Daycare staff pull the hair of the daycare children.
INVESTIGATION FINDINGS:
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LPA Thompson-Miller conducted an unannounced complaint inspection for the purpose of delivering finding for the above allegations. Upon arrival LPA observed 10 children (5 school age, 5 preschool/toddler) in care along with licensee spouse (assistant). LPA met with Licensee, Jacqueline Shipman.

Based on interviews conducted with staff, children and parents the above allegations are Unsubstantiated. There is not enough evidence or witnesses to substantiate, therefore, allegations are rendered Unsubstantiated at this time. 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 allegations occurred. At this time LPA unable to make determination that any violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4