191596242-1-7-2026-33-CC-KMAN-DQ4QTW-20260107112749

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191596242
Report Date: 01/07/2026
Date Signed: 01/07/2026 11:28:05 AM

Document Has Been Signed on 01/07/2026 11:28 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	POMONA HIGH/CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191596242
ADMINISTRATOR/ DIRECTOR:	KYM ALLEN		FACILITY TYPE:	830
ADDRESS:	475 BANGOR ST.		TELEPHONE:	(909) 623-1461
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 5	DATE:	01/07/2026
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:			TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

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On Wednesday Jan 7, 2025 at 9:00 Licensing Program Analyst (LPA) Kamile Martin conducted an unannounced annual inspection and met with Co Teacher Kerri Hawke Jere, guided LPA Martin went on a self guided tour of the facility. This is a infant classroom which serves 30 children ages 0-2 in room 85 toddler children. This program operates Monday to Friday 7:30 a.m. – 3:15 p.m. The facility operates at Pomona High School Campus.LPA observed 7 children in care with 3 staff.

All areas identified on the Facility Sketch were inspected. The facility consists of 1 classrooms and 1 playground. The following was observed: Infant room had 7 children and 3 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under active/visual supervision of a teacher during the tour. Sign in and out takes place at the main entrance area in the classroom Teacher and child ratio were observed and in compliance.

LPA entered the infant classroom lead by Kerri Hawke Jere, LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored underneath the sink cabinet making it inaccessible for children to reach. LPA observed the cribs to be free from bumper pads, pillows, toys, blankets, hanging above items. LPA observed two step trash bins with a lid, one for diapers and one for trash. LPA observed the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat. LPA observed children’s personal items to be in individual spaces. Sign in sheets were observed at the entrance. First aid kit was observed to be hanging near the entrance of the classroom

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Kamile Martin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

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

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: POMONA HIGH/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191596242
	VISIT DATE: 01/07/2026

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LPA observed central AC /heater and vents located on the ceiling. LPA observed the thermostat located in classroom and the temperature to be between 70-71 degrees. LPA observed the fire extinguishers located in the classroom and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 9/6/25 Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. LPA observed carbon monoxide detectors inside the classrooms and are operable. The last emergency drill was conducted on 12/19/25. First aid kits supplies are kept inside the classrooms and LPA observed the kits to be fully equipped. During this visit, Teacher Kerri confirmed 2 children in the classroom with food allergies a milk intolerance and no pork meat substitution. Children with allergies or substitutions will have meals substituted. Milk is substituted for children who have food allergies the menu shows substitutions and is documented.

LPA observed sleeping cots with individual tight-fitted sheets and cribs. Sheets are cleaned weekly by a cleaning service.

During this visit. LPA asked if there were any poisons, firearms, weapons or bodies of water. Teaching staff stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Teaching staff stated the ill isolation area takes place in the classroom near the cozy corner. Transportation services are not provided at this facility

LPA entered the outdoor play area. LPA observed the playground to be located in front of the classrooms. The outdoor area is gated completely. The equipment was observed to be free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed play structure equipment to be age appropriate and areas around or under climbing equipment, are cushioned with material that may absorb a fall. Facility was observed to have adequate shade. For outdoor water, staff bring out disposable cups and provide filter water as needed.

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Kamile Martin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: POMONA HIGH/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191596242
	VISIT DATE: 01/07/2026

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This program provides breakfast lunch and snack. Meals are prepared onsite at the high school cafeteria teaching staff alternate to pick up meals for the day. LPA informed staff that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For drinking water is filtered through a Brita water filter and bottled water is available for infants bottle formula.

LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including movable bins with tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects and rodents. Refrigerator was inspected for temperature of milk and expiration dates of cold food.

The following documents were posted on the licensing board: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), and PUB 269 Child Passenger System Poster, and Daily Schedule and Emergency disaster plan.

LPA did not review the children files and staff files not located at the site. LPA will review at a later date.

Teaching staff was reminded that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

All staff was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. Per maintenance and facilities Water will be tested this year Kym Allen Maintenance and operations for Pomona Unified.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP).

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Kamile Martin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: POMONA HIGH/CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191596242
	VISIT DATE: 01/07/2026

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LPA discussed the safe sleep regulations with staff and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Teaching staff was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with Kerri Hawke-Jere
Appeal Rights were provided and discussed.

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Kamile Martin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC809 (FAS) - (06/04)

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