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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197700306
Report Date: 08/26/2024
Date Signed: 09/05/2024 09:16:38 AM

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
04/05/2024 and conducted by Evaluator Annelise Villa
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240405151237
FACILITY NAME:SMITH FAMILY CHILD CAREFACILITY NUMBER:
197700306
ADMINISTRATOR:SMITH, CARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 208-7582
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:14CENSUS: 3DATE:
08/26/2024
UNANNOUNCEDTIME BEGAN:
04:08 PM
MET WITH:Carla SmithTIME COMPLETED:
06:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared Adults - Uncleared adults in the home providing care and supervision.

Conduct Inimical - Physical altercation between the licensee and her daughter in the presence of daycare child or children.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/5/2024, LPA amended report to reflect Licensee's signature on file. On 8/6/24, Licensing Program Analyst (LPA) Annelise Villa concluded a complaint investigation at the Smith Family Child Care Home and met with the Licensee, Carla Smith. During today’s visit, LPA observed 3 children in care with the licensee caring for them. The purpose of the inspection is to deliver complaint investigation findings. Investigation revealed an incident involving Licensee and a non-daycare child occurred on 4/3/2024, at the facility which resulted in police presence. Through interview, it was revealed no daycare children witness an altercation between Licensee and Child #1. Prior to police presence in the home, Licensee notified parents to pick up children for the day. All daycare children were picked up by a parent/guardian prior to Licensee's departure from the facility. Additionally, Adult #1 and Adult #2 were identified and determined not to be residents of the home and do not provide care and supervision to daycare children. Based on the interviews and documentation gathered, there is not a preponderance of evidence to prove the allegations have occurred, therefore the allegation is unsubstantiated. Exit interview was conducted, and a copy of this report, a Notice of Site Visit, and appeal rights were left in the mail box for Carla Smith, Licensee. A Notice of Site Visit must remain posted for 30 days. Removal of the posting is subject to a $100 civil penalty.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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