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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197411390
Report Date: 09/13/2023
Date Signed: 09/13/2023 10:32:31 AM

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
07/21/2023 and conducted by Evaluator Andrea Pittman
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230721095210
FACILITY NAME:LANCASTER UNITED METHODIST CHILDRENS CENTERFACILITY NUMBER:
197411390
ADMINISTRATOR:MEDINA, NICOLEFACILITY TYPE:
830
ADDRESS:918 W. AVE JTELEPHONE:
(661) 942-0812
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:24CENSUS: 15DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
08:37 AM
MET WITH:Director Nicole MedinaTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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2
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5
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7
8
9
Staff fell asleep while providing care for infants
Staff does not ensure child is properly cleaned during diaper changes
Staff left child in soiled diaper for extended period of time
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
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12
13
On 9/13/2023 at 8:37am, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced complaint visit to deliver the findings at the facility and was met by Director Nicole Medina who permitted entry to the facility. LPA toured the facility with the Director according to the facility sketch. Upon arrival, LPA observed 15 children with 5 staff members providing care and supervision.

On 7/24/2023, LPA toured the facility with the Director Nicole Medina. 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. In the weeks leading up to the complaint, the following represents what transpired at the center. 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: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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-20230721095210
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 CHILDRENS CENTER
FACILITY NUMBER: 197411390
VISIT DATE: 09/13/2023
NARRATIVE
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Allegation 1: The first allegation states that staff had fallen asleep while providing care. During interviews with staff, Staff 1 disclosed that they had fallen asleep very briefly while rocking an infant to sleep due to a health condition as revealed by Staff 1. Although, Staff 1 briefly dosed, the infant being held was not injured during the time Staff 1 slept. This is a Type B citation, see the LIC 9099D for the details.

Allegation 3: The third allegation states that staff did not ensure that an infant was not properly cleaned during diaper changes. The investigation revealed that there was one reported incidence where an infant was not properly cleaned after being changed by Staff 5. This is a Type B citation, see the LIC 9099D for the details.

Allegation 4: The fourth allegation states that staff left an infant in a soiled diaper for an extended period of time. The investigation revealed that Staff 4 had on several occasions left an infant in a soiled diaper after nap time and during feedings while the infant was sitting in a high chair. The infant did not sustain any injury despite being left in a soiled diaper for an extended period. This is a Type B citation, 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, 3, and 4; as a result, two Type B citations will be issued for all three allegations. A finding of substantiated means that allegations were valid because the preponderance of the evidence standard has been met.

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

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

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 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
07/21/2023 and conducted by Evaluator Andrea Pittman
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230721095210

FACILITY NAME:LANCASTER UNITED METHODIST CHILDRENS CENTERFACILITY NUMBER:
197411390
ADMINISTRATOR:MEDINA, NICOLEFACILITY TYPE:
830
ADDRESS:918 W. AVE JTELEPHONE:
(661) 942-0812
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:24CENSUS: 15DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
08:37 AM
MET WITH:Director Nicole MedinaTIME COMPLETED:
10:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee does not ensure staff are in good health to provide care for children
Staff spoke inappropriatly to child in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/13/2023 at 8:37am, Licensing Program Analysts (LPA) Andrea Pittman conducted an unannounced complaint visit to deliver the findings at the facility and was met by Director Nicole Medina who permitted entry to the facility. LPA toured the facility with the Director according to the facility sketch. Upon arrival, LPA observed 15 children with 5 staff members providing care and supervision.

LPA conducted an investigation into the allegation including observations, interviews, and record reviews. LPA interviewed the children, parents of the program, and any other relevant parties. As part of the investigation, LPA obtained the facility and children’s rosters, sign-in sheets, and other documents relevant to the investigation. The investigation revealed the following evidence:

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

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 12-CC-20230721095210
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 CHILDRENS CENTER
FACILITY NUMBER: 197411390
VISIT DATE: 09/13/2023
NARRATIVE
1
2
3
4
5
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8
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Allegation 2: On 7/21/2023, it was alleged that the facility was not ensuring staff are in good health to provide care to children. During the investigation, it was revealed during the record review and interview with relevant parties, that the facility is meeting requirements of ensuring the staff are fit to perform their job as the LIC 503-Health Screening was found in all files. The facility has been meeting regulation requirements by requiring staff to complete the health screen before hire and ensuring that the staff can meet their job obligations. After reviewing the relevant information obtained, there is not a preponderance of the evidence to support the allegation.

Allegation 5: On 7/21/2023, it was alleged that the staff spoke inappropriately to the children. During the investigation, it was revealed through interviews with relevant parties, there was no supporting evidence that staff, including Staff 3, spoke with children inappropriately; there were no interviewed parties that disclosed that staff were ever heard speaking using profane language about an infant or spoken to an infant inappropriately while in care. After reviewing the relevant information obtained, there is not a preponderance of the evidence to support the allegation.

After observations, record reviews, and interviews, it was determined that there was insufficient evidence that the facility was not ensuring staff are in good health to provide care to children and that staff spoke inappropriately to children in care. 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: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 12-CC-20230721095210
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 CHILDRENS CENTER
FACILITY NUMBER: 197411390
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2023
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful... meet his/her needs.
This requirement was not met as evidenced by:
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Director conducted a meeting and training to address personal rights. This was previously completed by the Director and verification was sent on 7/26/2023.
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Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above as Staff 1 did briefly fall asleep while holding an infant which poses a potential health, safety or personal rights risk to persons in care.
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Type B
09/27/2023
Section Cited
CCR
101428(b)
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101428 Infant Care Personal Services (b) The infant shall be kept clean and dry at all times.

This requirement is not met as evidenced by
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Director conducted a meeting and training to address diaper changing policies. This was previously completed by the Director and verification was sent on 7/26/2023.
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Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above as Staff 5 did not properly clean an infant during a diaper change by leaving waste on the infant and Staff 4 left an infant in a soiled diaper for an extended period of time 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: 09/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5