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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 344501808
Report Date: 08/06/2026
Date Signed: 08/06/2026 11:02:45 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/15/2026 and conducted by Evaluator Jennie Tedlos
COMPLAINT CONTROL NUMBER: 53-CC-20260615093142
FACILITY NAME:EDWARDS, SHANAFACILITY NUMBER:
344501808
ADMINISTRATOR:EDWARDS, SHANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 957-8782
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:14CENSUS: 0DATE:
08/06/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Shana EdwardsTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Licensee left child unattended.
INVESTIGATION FINDINGS:
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On August 6, 2026, Licensing Program Analyst (LPA) Jennie Tedlos and Licensing Program Manager (LPM) Karyn Guerra met with Licensee (L1), Shana Edwards to deliver the findings of the complaint investigation regarding the above allegation. L1 has since moved from the facility that the complaint was filed under. Therefore, LPA and LPM met with L1 at the location that L1 moved to. A Change of Location Application is pending with the Department. LPA observed 0 children in care at this location.

LPA Tedlos conducted an investigation regarding the complaint allegations listed above. LPA toured the facility and conducted interviews. LPA obtained pertinent information and documents to assist with the investigation.

It was alleged that L1 left a child (C1) unattended. During the incident on 06/12/26, C1 was dropped off by their parent (P1) at the unlocked facility, L1 was sleeping at another residence at this time. C1 then walked out...
Report Continues on 9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
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 6
Control Number 53-CC-20260615093142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: EDWARDS, SHANA
FACILITY NUMBER: 344501808
VISIT DATE: 08/06/2026
NARRATIVE
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...of the facility and was found about a mile and a half away from the facility at about 4:30AM by a member of the community. L1 was not aware that C1 was dropped off or had left the facility at this time. The Elk Grove Police Department (EGPD) secured C1 and met with P1 and L1 shortly after.

During interviews L1 and P1 state that C1 was scheduled for the 3:00 AM drop off, however there was a miscommunication between them, leading to C1 being dropped off and walking out of the facility unsupervised. L1 states that C1 was dropped off outside of L1’s and C1’s normal day care hours.

Based on interviews, file review, and observations conducted the preponderance of evidence standard has been met, therefore the above allegation, the Licensee left a child unattended, is found to be SUBSTANTIATED.

Three (3) Type A Deficiencies regarding Inimical Conduct, Absence of Supervision, and Personal Rights has been assessed on the subsequent page.

LPA informed L1, Shana Edwards, that this report dated 08/06/2026 documents Three (3) Type-A citations.

Exit interview was conducted and the report was reviewed with L1, Shana Edwards. Appeal rights were provided.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 53-CC-20260615093142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: EDWARDS, SHANA
FACILITY NUMBER: 344501808
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2026
Section Cited
CCR
1012402(a)(3)
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(3) Conduct in the operation … of a family day care home which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility …
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Incident has been elevated to our legal department for consult. L1 has moved and has no control of property. Facility is closed.
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This requirement was not met as evidenced by: On 06/12/26 a C1 was left unsupervised at the facility and exited the facility without L1’s knowledge. This poses an immediate risk to the health and safety of C1 in care.
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Type A
08/07/2026
Section Cited
HSC
1596.99(c)(3)(c)
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(c) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues ... (3) Absence of supervision, including…a child left unattended...
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Incident has been elevated to our legal department for consult. L1 has moved and has no control of property. Facility is closed.
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This requirement was not met as evidenced by: On 06/12/26 a C1 was left unsupervised at the facility and exited the facility without L1’s knowledge. This poses an immediate risk to the health and safety of C1 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.
SUPERVISOR'S NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 53-CC-20260615093142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: EDWARDS, SHANA
FACILITY NUMBER: 344501808
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2026
Section Cited
CCR
102423(a)(2)
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(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by licensee regardless of consent or authorization from child’s authorized representative. These rights include...to the following: (2) To receive safe, healthful, and...
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Incident has been elevated to our legal department for consult. L1 has moved and has no control of property. Facility is closed.
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... comfortable accommodations, furnishings, and equipment.
This requirement was not met as evidenced by: On 06/12/26 a C1 was left unsupervised at the facility and exited the facility through an unlocked door. This poses an immediate risk to the health and safety of C1 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.
SUPERVISOR'S NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/15/2026 and conducted by Evaluator Jennie Tedlos
COMPLAINT CONTROL NUMBER: 53-CC-20260615093142

FACILITY NAME:EDWARDS, SHANAFACILITY NUMBER:
344501808
ADMINISTRATOR:EDWARDS, SHANAFACILITY TYPE:
810
ADDRESS:9863 TED KOLB WAYTELEPHONE:
(916) 957-8782
CITY:ELK GROVESTATE:CAZIP CODE:
95624
CAPACITY:14CENSUS: 0DATE:
08/06/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Shana EdwardsTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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2
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9
Licensee is not following terms of license.
INVESTIGATION FINDINGS:
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On August 6, 2026, Licensing Program Analyst (LPA) Jennie Tedlos and Licensing Program Manager (LPM) Karyn Guerra met with Licensee (L1), Shana Edwards to deliver the findings of the complaint investigation regarding the above allegations. L1 has since moved from the facility that the complaint was filed under. Therefore, LPA and LPM met with L1 at the location that L1 moved to. A Change of Location Application is pending with the Department. LPA observed 0 children in care at this location.

LPA Tedlos conducted an investigation regarding the complaint allegation listed above. LPA toured the facility and conducted interviews. LPA obtained pertinent information and documents to assist with the investigation.

It was alleged that L1 is not following terms of license. There was a concern that L1 was not living at the facility. During an incident that occurred on 06/12/26, a Child (C1) was brought to the facility at...
Report continues on 9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 53-CC-20260615093142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: EDWARDS, SHANA
FACILITY NUMBER: 344501808
VISIT DATE: 08/06/2026
NARRATIVE
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...approximately 3:00AM for a scheduled drop off. The child's parent (P1) opened the facility’s unlocked door and let C1 into the home without handing C1 off to L1 face to face. At this time, L1 was not at the facility and was sleeping at another residence. There was no one to supervise C1 at the facility. L1 states that she was in the process of moving out of the facility and was sleeping at her new location. During the investigation, LPA observed packed belongings and the Department received a Change of Location Application.

During interviews L1 and P1 state that C1 was scheduled for the 3:00 AM drop off, however there was a miscommunication between them, leading C1 being dropped off and walking out of the facility unsupervised. L1 states that C1 was dropped off outside of L1’s and C1’s normal day care hours.

Based on lack of clear corroborating evidence, the above allegation, the Licensee is not following the terms of the license, could not be substantiated or dismissed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the findings are UNSUBSTANTIATED.

Exit interview was conducted and the report was reviewed with L1, Shana Edwards. Appeal rights were provided.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6