376616871-6-27-2019-20-CC-JGAY-BEFUYF-20190726155954

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376616871
Report Date: 06/27/2019
Date Signed: 06/27/2019 03:39:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/19/2019 and conducted by Evaluator Michelle Hood

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20190419135706

FACILITY NAME:	DEJOHNETTE, MICHELLE FAMILY CHILD CARE		FACILITY NUMBER:	376616871
ADMINISTRATOR:	MICHELLE DEJOHNETTE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 955-8568
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92114
CAPACITY:	14	CENSUS: 6	DATE:	06/27/2019
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Michelle Dejohnette, Licensee		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee is not maintaining staff records.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Michelle Hood arrived to conduct an unannounced inspection to deliver complaint findings for the above listed allegation. LPA met with Licensee.

It was alleged licensee is not maintaining staff records. On 04/26/2019, Licensee admits she did not have complete staff records available for LPA. LPA and Licensee discussed personnel records shall be maintained for each employee. LPA provided licensee with a copy of Employee Rights LIC 9052 and Report Child Abuse LIC 9108 for future staff. On 06/27/2019, LPA reviewed current staff files. The preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 3, is being cited on the attached LIC 9099D.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

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 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/19/2019 and conducted by Evaluator Michelle Hood

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20190419135706

FACILITY NAME:	DEJOHNETTE, MICHELLE FAMILY CHILD CARE		FACILITY NUMBER:	376616871
ADMINISTRATOR:	MICHELLE DEJOHNETTE		FACILITY TYPE:	810
ADDRESS:	2156 ORIOLE STREET		TELEPHONE:	(619) 955-8568
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92114
CAPACITY:	14	CENSUS: 6	DATE:	06/27/2019
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Michelle Dejohnette, Licensee		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee uses physically aggressive behaviors upon children.
Licensee served expired food to children.
Licensee operating out of ratio.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Michelle Hood arrived to conduct an unannounced inspection to deliver complaint findings for the above listed allegations. LPA met with Licensee.

It was alleged licensee uses physically aggressive behaviors upon children, licensee served expired food to children, and licensee is operating out of ratio. Licensee denies the above listed allegations. Staff members and daycare children stated facility staff do not use physically aggressive behavior towards children in care; however, one child stated licensee talks loudly. Staff members and daycare parents have not observed licensee operating out of ratio; however, there were no records available to support these statements. LPA observed children playing and reading with staff. LPA inspected licensee’s two (2) refrigerators and pantries; however, no expired food observed during inspection. LPA reviewed three (3) Child Nutrition Program of Southern California site

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 20-CC-20190419135706

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: DEJOHNETTE, MICHELLE FAMILY CHILD CARE	FACILITY NUMBER: 376616871
	VISIT DATE: 06/27/2019

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

review reports. Child Nutrition Program site monitor stated she has not observed Licensee providing expired food to children in care. Due to conflicting statements obtained and observations made during the course of the investigation, the above allegations is found to be UNSUBSTANTIATED meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Licensee was provided appeal rights (LIC9058 01/16) and their signature on this form acknowledges receipt of these rights. Provided Notice of Site Visit. LPA observed Licensee post the LIC 9213. No deficiencies cited.

An exit interview was conducted with Licensee.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 20-CC-20190419135706

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: DEJOHNETTE, MICHELLE FAMILY CHILD CARE	FACILITY NUMBER: 376616871
	VISIT DATE: 06/27/2019

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	A type “B” deficiency was cited during today’s inspection. Licensee was provided appeal rights (LIC9058 01/16) and their signature on this form acknowledges receipt of these rights. Provided Notice of Site Visit. LPA observed Licensee post LIC 9213-Notice of Site Visit. An exit interview was conducted with Licensee.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 20-CC-20190419135706

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: DEJOHNETTE, MICHELLE FAMILY CHILD CARE	FACILITY NUMBER: 376616871
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/27/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/26/2019 Section Cited CCR 102416.1(a)	1 2 3 4 5 6 7	Personnel Records: (a) Personnel records shall be maintained on each employee…This requirement is not met as evidenced by: Based on Licensee’s admission and LPA’s review personnel files, it was	1 2 3 4 5 6 7	On 06/27/2019, LPA reviewed current staff file. Licensee stated new staff will ensure complete documents before employment and create a file.
	8 9 10 11 12 13 14	determined, licensee failed to maintain records in two (2) personnel files. This poses a potential risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

LIC9099 (FAS) - (06/04)

Page: 3 of 5