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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364812086
Report Date: 04/25/2024
Date Signed: 04/25/2024 02:03:31 PM

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
03/19/2024 and conducted by Evaluator Carol Heath
COMPLAINT CONTROL NUMBER: 12-CC-20240319170031
FACILITY NAME:SJUSD-PHELAN ELEMENTARY SCHOOL STATE PRESCHOOLFACILITY NUMBER:
364812086
ADMINISTRATOR:BRENDA NOPWASKEYFACILITY TYPE:
850
ADDRESS:4167 PHELAN ROADTELEPHONE:
(760) 868-3036
CITY:PHELANSTATE: CAZIP CODE:
92371
CAPACITY:48CENSUS: 17DATE:
04/25/2024
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Vicki DenbleykerTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Allegation #1- Qualifications
Allegation #2- Ratio
Allegation #3- Reportting Requirements
INVESTIGATION FINDINGS:
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On 4/25/2024, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced follow-up complaint inspection and met with the site supervisor, Vicki Denbleyker The purpose of the inspection was to deliver the findings of the above complaint allegations. During today’s visit, LPA observed 17 childcare children ( 4 to 5 yrs.) present with site supervisor, 1 teacher and 2 assistants.

During the course of the investigation of this complaint, LPA Heath observed the facility and conducted interviews with the site supervisor, teachers, and other related parties. The interviews revealed inconsistencies in the explanations for the incident in the facility.

This agency has investigated the complaint. At this time, it is determined that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur; therefore, at this time, the above allegations are Unsubstantiated—no deficiency given at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
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-20240319170031
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: SJUSD-PHELAN ELEMENTARY SCHOOL STATE PRESCHOOL
FACILITY NUMBER: 364812086
VISIT DATE: 04/25/2024
NARRATIVE
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

An exit interview was conducted with the site Supervisor, Vicki Denbleyker. The director was provided with a copy of their appeal rights (LIC 9058), and their signature on this form acknowledges receipt of these forms.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2