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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 367700136
Report Date: 08/25/2026
Date Signed: 08/25/2026 03:08:48 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 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
07/07/2026 and conducted by Evaluator Annelise Villa
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20260707142714
FACILITY NAME:DAVIS FAMILY CHILD CAREFACILITY NUMBER:
367700136
ADMINISTRATOR:DAVIS, TIFFANYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 949-1580
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:14CENSUS: 0DATE:
08/25/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Tiffany Davis, LicenseeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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1. Personal Rights: Licensed did not prevent adult in home from smoking in the presence of day care children
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Annelise Villa and Ruby Rosales conducted a follow up complaint investigation related to the allegations above and to deliver findings. LPA disclosed the purpose of the investigation and was granted entry into the facility by Licensee. A tour of the facility was conducted. No children were present at the time of inspection. No deficiencies were observed during the tour.

During the investigation, LPA collected pertinent documentation, completed a review of records, and conducted confidential interviews with staff and children. The interviews revealed that on May 28, 2026, the Licensee was undergoing an inspection related to becoming a foster parent. At that time, the Licensee’s neighbor was smoking in their backyard. The Licensee stated that she had previously asked the neighbor not to smoke when children were present at the childcare facility. According to the Licensee, when smoke is detected on the childcare premises, the children remain indoors, as she cannot control or direct the neighbor’s activities. Licensee denies having an unfingerprinted adult inside the home smoking.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2026
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 2
Control Number 12-CC-20260707142714
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DAVIS FAMILY CHILD CARE
FACILITY NUMBER: 367700136
VISIT DATE: 08/25/2026
NARRATIVE
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Based on conflicting statements, this allegation has been unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are UNSUBSTANTIATED.

Exit interview conducted with Licensee. A copy of this report, appeal rights and Notice of Site Visit were left with Licensee.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2