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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198012306
Report Date: 12/05/2024
Date Signed: 12/05/2024 04:59:57 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2024 and conducted by Evaluator Stephanie Li
COMPLAINT CONTROL NUMBER: 33-CC-20240916153516
FACILITY NAME:DEJONG FAMILY CHILD CAREFACILITY NUMBER:
198012306
ADMINISTRATOR:DEJONG, AIDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 764-4077
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY:14CENSUS: 13DATE:
12/05/2024
UNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Licensee Aida DejongTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Child was not picked up from school
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA)s Stephanie Li and Joanne Solorio Campos conducted an unannounced site inspection to present the findings of the above complaint allegations. Licensee was not present upon arrival. Two assistants were present with 13 children. Licensee Aida Dejong arrived at 3:15pm to whom the reason for the visit was explained. Licensee provided a tour of the facility. Present during the inspection was 2 staff, 1 therapists and 13 children.

During the investigation licensing staff conducted interviews with licensee, parents, and school staff.
Licensing staff also obtained several documents related to the complaint allegation, including but not limited to, a copy of the facility roster, LIC279B and a parent contract. Children’s files were also reviewed during this investigation.

*Continued on next page....
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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 3
Control Number 33-CC-20240916153516
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: DEJONG FAMILY CHILD CARE
FACILITY NUMBER: 198012306
VISIT DATE: 12/05/2024
NARRATIVE
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Based on statements obtained from parent interviews, disclosures were made from parents regarding licensee not picking up the children from school, corroborating the allegation, therefore, the above allegations are deemed SUBSTANTIATED. California Code of Regulations, Title 22 are being cited on the attached LIC9099D.

At this time, a deficiency is being cited. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


Exit interview was reviewed and appeal rights provided with Licensee Aida Dejong.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20240916153516
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: DEJONG FAMILY CHILD CARE
FACILITY NUMBER: 198012306
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2024
Section Cited
CCR
102417(a)
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(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times.

This requirement was not met evidenced by:
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Per licensee, she has updated her parent contract to indictae that the provider is not providing transportation to and from school. LPA's observed that Licensee's contract for parents state that transportation from school is the parents responsibility. LPA's obtained a copy of new contract during visit.
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Based on interviews, licensee did not pick up school aged children from school when parent/provider agreement service was agreed upon, which poses/posed a health and safety risk to children in care.
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LPA's advised that amendment to parent contract needs to be provided to all families in care and have parents sign receipt.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3