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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191201899
Report Date: 11/07/2024
Date Signed: 11/07/2024 04:46:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 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
08/29/2024 and conducted by Evaluator Andrea Pittman
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240829084221
FACILITY NAME:LANCASTER UNITED METHODIST CHURCH PRE SCHOOLFACILITY NUMBER:
191201899
ADMINISTRATOR:MEDINA, NICOLEFACILITY TYPE:
850
ADDRESS:918 WEST AVENUE JTELEPHONE:
(661) 942-0812
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:58CENSUS: 24DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Director Tammy DamonTIME COMPLETED:
04:05 PM
ALLEGATION(S):
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Allegation 1: Staff handled day care child in a rough manner
INVESTIGATION FINDINGS:
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On 11/7/2024, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced complaint visit to deliver the findings at the facility and was met by the Facility Representative who permitted entry to the facility. LPA toured the facility with the Director according to the facility sketch. Upon arrival, LPA observed 24 children with 8 staff members providing care and supervision.

During this investigation, LPA received pertinent documents related to this investigation, which included the facility’s staff and children’s rosters, personnel records, and other relevant investigation documents. The investigation revealed the following information:

Continue to next page
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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 5
Control Number 12-CC-20240829084221
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LANCASTER UNITED METHODIST CHURCH PRE SCHOOL
FACILITY NUMBER: 191201899
VISIT DATE: 11/07/2024
NARRATIVE
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Allegation 1: The first allegation states staff handled a daycare child in a rough manner. During the observation, interviews, and record review, the following was revealed: Child 4 was present in the classroom during nap time with the other day care children. At that time, Child 4 did not want to nap nor do the other quiet time activities that was offered to children and caused a disruption in the classroom and began running away from the staff and into another area. Staff 3 admitted to picking up Child 4 around the stomach to control their behavior from causing a disruption while the other children slept; the staff did not visually observe the child for injuries after picking the child up. The staff in the classroom stated they were not able to control Child 4's behavior and requested additional help from the staff. Staff 4 attempted to stop Child 4 from running and causing a disruption in the classroom. Child 4 was then taken to another on-limits room in the facility. Child 4 broke away from staff and ran into an off-limits area for their age group. Staff 4 admitted to grabbing the child by their forearm to stop them from continuing into the off-limits area for their age group; however, Staff 4 did not observe any injuries to Child 4. The staff stated that Child 4 did not say that they were injured after being handled by the staff. It is unknown if the handling of Staff 3 and Staff 4 caused the injuries Child 4 sustained which is a very minor bruise on the right arm and a minor scratch under the left armpit. Additionally, Child 4 stated they did not notify the staff of the injuries when they occurred and was unable to show the staff the injuries without removing their clothing. The injuries to Child 4 were found at a later time. The staff stated that they were unaware of the injuries the child sustained. Based on the admissions, the staff could have handled Child 4 in a different manner that did not violate the child's personal rights. This is a violation of Title 22 Regulations, see the LIC 9099D for the details.

Based on information obtained, observations, and interviews with relevant complaint parties, the Allegation is deemed substantiated for Allegations 1; as a result, a Type B violation will be cited. A finding of substantiated means that allegations were valid because the preponderance of the evidence standard has been met. As a result of the investigation, the facility was found to be in noncompliance with Title 22 Regulations; as a result, one Type B violation will be cited, see the LIC 9099D for the details.

An exit interview was conducted, and a copy of this report was provided to the Facility Representative along with the Notice of Site Visit and Appeal Rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 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
08/29/2024 and conducted by Evaluator Andrea Pittman
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240829084221

FACILITY NAME:LANCASTER UNITED METHODIST CHURCH PRE SCHOOLFACILITY NUMBER:
191201899
ADMINISTRATOR:MEDINA, NICOLEFACILITY TYPE:
850
ADDRESS:918 WEST AVENUE JTELEPHONE:
(661) 942-0812
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:58CENSUS: 24DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Director Tammy DamonTIME COMPLETED:
04:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation 2: Day care child sustained unexplained injuries
INVESTIGATION FINDINGS:
1
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3
4
5
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7
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10
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13
On 11/7/2024, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced complaint visit to deliver the findings at the facility and was met by the Facility Representative who permitted entry to the facility. LPA toured the facility with the Director according to the facility sketch. Upon arrival, LPA observed 24 children with 8 staff members providing care and supervision.

During this investigation, LPA received pertinent documents related to this investigation, which included the facility’s staff and children’s rosters, personnel records, and other relevant investigation documents. The investigation revealed the following information:

Continue to next page
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 12-CC-20240829084221
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LANCASTER UNITED METHODIST CHURCH PRE SCHOOL
FACILITY NUMBER: 191201899
VISIT DATE: 11/07/2024
NARRATIVE
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Allegation 2: The second allegation states that a daycare child sustained unexplained injuries. During the observation, interviews, and record review, the following was revealed: Child 4 was present in the classroom during nap time with the other day care children. At that time, Child 4 did not want to nap nor do the other quiet time activities that was offered to children and caused a disruption in the classroom and began running away from the staff and into another area. Staff 3 admitted to picking up Child 4 around the stomach to control their behavior from causing a disruption while the other children slept; the staff did not visually observe the child for injuries after picking the child up. The staff in the classroom stated they were not able to control Child 4's behavior and requested additional help from the staff. Staff 4 attempted to stop Child 4 from running and causing a disruption in the classroom. Child 4 was then taken to another on-limits room in the facility. Child 4 broke away from staff and ran into an off-limits area for their age group. Staff 4 admitted to grabbing the child by their forearm to stop them from continuing into the off-limits area for their age group; however, Staff 4 did not observe any injuries to Child 4. The staff stated that Child 4 did not say that they were injured after being handled by the staff. It is unknown if the handling of Staff 3 and Staff 4 caused the injuries Child 4 sustained which is a very minor bruise on the right arm and a minor scratch under the left armpit. Additionally, Child 4 stated they did not notify the staff of the injuries when they occurred and was unable to show the staff the injuries without removing their clothing. The injuries to Child 4 were found at a later time. The staff stated that they were unaware of the injuries the child sustained. As a result, there is no way to clearly identify when and where the injuries occurred to the child.

After observations, record reviews, and interviews, it was determined that there was insufficient evidence that a daycare child sustained unexplained injuries. The allegations could not be corroborated with the evidence found during the investigation. Therefore, the allegations have been found unsubstantiated. Although, the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the facility operated in violation of policy in this circumstance.

An exit interview was conducted, and a copy of this report was provided to Director along with the Notice of Site Visit and Appeal Rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 12-CC-20240829084221
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LANCASTER UNITED METHODIST CHURCH PRE SCHOOL
FACILITY NUMBER: 191201899
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/21/2024
Section Cited
CCR
101223(a)(1)
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101223 Personal Rights (a)The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by:
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Director will staff complete a training on personal rights and will submit proof via e-mail no later than 11/21/2024.
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Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above by Staff 3 and Staff 4 handling Child 4 in a rough manner which poses a potential health, safety or personal rights risk to persons in care.
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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.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5