197411390-5-11-2022-12-CC-CYAS-CFDUDK-20220614152937

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197411390
Report Date: 05/11/2022
Date Signed: 05/11/2022 02:51:46 PM

Unsubstantiated

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
04/06/2022 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20220406111003

FACILITY NAME:	LANCASTER UNITED METHODIST CHILDRENS CENTER		FACILITY NUMBER:	197411390
ADMINISTRATOR:	DAMON, TAMMY		FACILITY TYPE:	830
ADDRESS:	918 W. AVE J		TELEPHONE:	(661) 942-0812
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	24	CENSUS: 15	DATE:	05/11/2022
		UNANNOUNCED	TIME BEGAN:	10:49 AM
MET WITH:	Director Tammy Damon		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Allegation 1: Facility did not prevent the spread of multiple communicable diseases.

INVESTIGATION FINDINGS:

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On May 11, 2022 at 10:49AM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection to deliver findings on the above allegation. LPA disclosed the purpose of inspection and was granted entry by Assistant Director, Nicole Medina. Director Tammy Damon met LPA at 11:00AM as she is participating in pictures for picture day with the children. Director led LPA on a tour of the facility. LPA observed 15 infants with 7 staff on association list.

During investigation, LPA conducted interviews with staff, parents, Department of Public Health representative (DPH1), and obtained facility records. LPA also conducted inspection of facility freezer, refrigerator, and observed the frozen breast milk stored separately. Interviews disclosed two infants in the same family were diagnosed with an illness, but no other children or staff had tested positive for the illness.

Unsubstantiated

Estimated Days of Completion: 35

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Brigitte Tsutaoka
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022

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-20220406111003

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 CHILDRENS CENTER	FACILITY NUMBER: 197411390
	VISIT DATE: 05/11/2022

NARRATIVE

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Staff disclosed they ensure expiration dates are current, powder formula is stored with the infant's name and the date it was opened, and staff never serve children expired or spoiled food. Staff also disclosed they are verifying infant wellness by taking temperatures, observing bowel movements, and observe general behavior changes including lethargy. The facility has an illness policy that excludes a child until they are fever free for 24 hours. Parent interviews disclosed their children had not sustained any stomach ailments, but have experienced minor colds and respiratory illness.

LPA inspected freezer and refrigerator filled with fresh food labeled with expiration dates and receipt dates. Food was not observed to have any mold or in any stage of spoilage. LPA observed frozen breast milk labeled with the date it was compressed maintained frozen and within safe storage date.

LPA also obtained a statement from the Department of Public Health (DPH) who disclosed an outbreak is 3 or more cases in separate families or classrooms, and 2 cases in the same family does not qualify as an outbreak. Additionally, DPH disclosed the source of contracting an illness is very difficult to identify, but an investigation will take place in the instance of an outbreak.

Based on evidence obtained and interviews conducted, the above allegation is deemed 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 violation 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.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Brigitte Tsutaoka
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022

LIC9099 (FAS) - (06/04)

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