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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197418896
Report Date: 11/07/2023
Date Signed: 11/07/2023 04:01:06 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
09/13/2023 and conducted by Evaluator Joselito DelMundo
COMPLAINT CONTROL NUMBER: 12-CC-20230913110531
FACILITY NAME:HOWARD FAMILY CHILD CAREFACILITY NUMBER:
197418896
ADMINISTRATOR:HOWARD, EDNA M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 718-3163
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:14CENSUS: DATE:
11/07/2023
UNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Edna HowardTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Provider is operating beyond the scope of license.
INVESTIGATION FINDINGS:
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On 11/07/2023, Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted a follow up on the complaint investigation at the facility to deliver complaint investigation findings. Upon arrival LPA met with licensee, Edna Howard. LPA observed four children present in the facility.

During the investigation, LPA conducted interview with the licensee and other related parties. Sign in and out sheets from CCRC were gathered, consolidated, and reviewed. Based on records review, licensee is not providing care for more children and is within the capacity stated in her license.

After observations and interviews with parties related to the allegations, it was determined that the allegation: Provider is operating beyond the scope of license, could not be collaborated.

Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the licensee was operating beyond the capacity stated in her license, therefore the above
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023
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 2
Control Number 12-CC-20230913110531
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: HOWARD FAMILY CHILD CARE
FACILITY NUMBER: 197418896
VISIT DATE: 11/07/2023
NARRATIVE
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Pg 2

allegation is deemed Unsubstantiated. No deficiencies were cited during this inspection.

An exit interview was conducted, and a copy of this report was provided to licensee Edna Howard along with Notice of Site Visit and Appeal Rights.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2