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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197750032
Report Date: 05/03/2023
Date Signed: 05/03/2023 12:56:06 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
02/10/2023 and conducted by Evaluator Andrea Pittman
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230210085532
FACILITY NAME:LIFE SOURCE PREPARATORY PRESCHOOLFACILITY NUMBER:
197750032
ADMINISTRATOR:CULPEPPER, DEBERAEFACILITY TYPE:
850
ADDRESS:44709 BEECH AVETELEPHONE:
(661) 789-7663
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:44CENSUS: 29DATE:
05/03/2023
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Preschool Director Shannon AlfordTIME COMPLETED:
12:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights: Staff member had inappropriate contact with Child 1
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/3/2023 at 10:04am, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced complaint investigation at the facility and to deliver complaint investigation findings. Upon arrival, LPA Pittman met with Preschool Director Shannon Alford and was permitted entry and a tour of the facility according to the facility sketch. LPA observed 29 children in care with 10 staff providing care and supervision.

During the course of the investigation, LPA Pittman interviewed children, staff, and any other relevant parties. LPA Pittman obtained the children’s roster, staff roster, and other documents relevant to the investigation. Part of the investigation was conducted by the Department Investigation Bureau, Investigator Peter Zertuche. Investigator Zertuche reported Child 1 provided inconsistent statements with the allegation. After observations, record review, and interviews with parties related to the allegations, it was found that children did not disclose experiencing or witnessing any inappropriate contact with staff at the facility. The allegation could not be corroborated. Therefore, the allegation has been found unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
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-20230210085532
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: LIFE SOURCE PREPARATORY PRESCHOOL
FACILITY NUMBER: 197750032
VISIT DATE: 05/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 Although, the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the facility is not providing a safe and healthful environment. Consequently, the above allegation is unsubstantiated.

An exit interview was conducted and a copy of this report was provided to Preschool Director Shannon Alford along with Notice of Site Visit and Appeal Rights.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
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