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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197700543
Report Date: 05/03/2023
Date Signed: 05/03/2023 10:59:04 AM

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
02/14/2023 and conducted by Evaluator Justeene Tamayo
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230214154056
FACILITY NAME:THOMAS FAMILY CHILD CAREFACILITY NUMBER:
197700543
ADMINISTRATOR:ANDREANA THOMASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 860-8498
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:14CENSUS: 2DATE:
05/03/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Andreana Thomas, LicenseeTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Allegation:

Level of Care: Licensee is not providing care at least 80 percent of the time.
INVESTIGATION FINDINGS:
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On 05/03/23 Licensing Program Analyst (LPA) Justeene Tamayo met with licensee Andreana Thomas for the purpose of concluding the investigation concerning the above complaint allegation. LPA toured the facility and observed 1 infant and 1 preschool child in care.

The investigation consisted of interviews with licensee and other complaint relevant parties including the review of supportive documentation. Based on conflicting statements obtained during interviews conducted with parents, licensee and other relevant complaint parties, the allegation may be valid but cannot be proven.

Therefore, based on the evidence gathered the allegation is unsubstantiated at this time. 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 allegation occurred.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
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-20230214154056
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: THOMAS FAMILY CHILD CARE
FACILITY NUMBER: 197700543
VISIT DATE: 05/03/2023
NARRATIVE
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Licensee was informed that if the Department obtains additional evidence to prove the allegation occurred, the complaint will be reopened, and the finding will be changed from unsubstantiated to substantiated.
An exit interview was conducted, and a copy of this report was read and provided to the licensee on this date, along with a copy of her appeal rights and Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2