<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197418889
Report Date: 10/25/2023
Date Signed: 10/25/2023 01:22:30 PM

Unsubstantiated


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
10/24/2023 and conducted by Evaluator Isabel Ortega
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20231024101428
FACILITY NAME:GRIJALVA FAMILY CHILD CAREFACILITY NUMBER:
197418889
ADMINISTRATOR:GRIJALVA, AIDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 396-2746
CITY:ARLETASTATE: CAZIP CODE:
91331
CAPACITY:14CENSUS: 6DATE:
10/25/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Aida Grijalva, LicenseeTIME COMPLETED:
01:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation: Licensee did not provide written notice of intent to operate a Family Child Care Home to the property owner/landlord

Allegation: Licensee did not obtain the written consent of the property owner/landlord to increase the home's capacity
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On October 25, 2023 LPA Isabel Ortega conducted an unannounced complaint investigation to investigate the two allegations regarding record review. LPA Ortega announced the purpose of inspection and was granted entry by licensee. Upon entry LPA observed six children in care and three assistants fingerprint cleared and associated providing care and supervision.
It was alleged Licensee did not provide written notice of intent to operate a Family Child Care Home to the property owner/landlord. Also, it was alleged Licensee did not obtain the written consent of the property owner/landlord to increase the home's capacity. Based on the information obtained during interviews, and LPA’s File review, it is determined that the above allegation is deemed Unsubstantiated. A finding that is unsubstantiated means, although the allegation may have happened or is valid, at the time of the investigation there is no preponderance of the evidence to prove that the alleged violation occurred. LPA observed forms LIC 9151 Property Owner/Landlord Notification Family Child Care Home signed by licensee and landlord (both husband and wife) on May 06, 2013. LPA also observed LIC 9149 Property Owner/Landlord Consent on file dated May 06, 2013.
An exit interview was conducted, appeal rights, notice of site visit, and a copy of this report was provided to licensee on this date.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023
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 1