198012306-5-2-2024-33-CC-SLII-D4VUQQ-20240502154731

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012306
Report Date: 05/02/2024
Date Signed: 05/02/2024 03:47:40 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/02/2024 03:47 PM - 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:	DEJONG FAMILY CHILD CARE		FACILITY NUMBER:	198012306
ADMINISTRATOR/ DIRECTOR:	DEJONG, AIDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 764-4077
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	05/02/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Licensee Aida Dejong		TIME VISIT/ INSPECTION COMPLETED:	04:15 PM

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	At 1:00pm, Licensing Program Analysts (LPA)s Stephanie Li and Mary Silva conducted an unannounced annual random inspection to the above facility. A risk assessment was conducted upon entry. LPA met with Licensee, Aida Dejong who guided analysts on a tour of the facility. Visit was translated in Spanish. Per Licensee, there are currently 14 children enrolled. A current children’s roster was available for review. There was 4 adult and 5 children (out of 5, 1 is an infant) present upon arrival. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Monday-Friday, 5:00am-5:00pm. Per licensee, she has 5 dogs and 4 cats. Dogs stay in off limits bedroom during child care hours. Cats were observed to roam in the garage and front yard. This is a one story home which consists of 3 bedrooms, 2 bathroom, living room (day care room), kitchen/dining room, (enclosed patio) play room, front yard, driveway, back yard (fenced) and pool. Currently residing in the home is 3 adult and 1 minor child. Per licensee, areas off limits to children and parents include 3 bedrooms, 1 restroom, kitchen, garage, and back yard. LPA toured all areas used by children during this visit. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection. Cleaning compounds, and medications were observed to be inaccessible to children. Per licensee, there are no poisons kept in the home. The restroom that children use was observed to be safe and sanitary. There is telephone service via cellphone that stays at the facility during operation hours. Inside the home is observed to be clean and orderly with central air and heat. There are toys available for children. Napping crib and cots were observed. LPA’s observed children napping in the closed patio. The French doors leading into the patio were closed and children could not be heard. LPA’s advised that children need to be napping in the inside of the home and suggested having children nap in the play area. A technical violation is being issued per Infant safe sleep regulations 102425(j)(5)(a). Page 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

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

LIC809 (FAS) - (06/04)

Page: 1 of 5

Document Has Been Signed on 05/02/2024 03:47 PM - It Cannot Be Edited

Created By: Stephanie Li On 05/02/2024 at 02:26 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 05/02/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/03/2024 Section Cited CCR 102417(b)	1 2 3 4 5 6 7	102417(b) Operation of a Family Child Care Home....(b)The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement was not met evidenced by:	1 2 3 4 5 6 7	Per licensee, she is going to remove all fecal matter/droppings from the front play yard and take photos from different angles. She will email photos to LPA S Li via email by 5/3/24.
	8 9 10 11 12 13 14	Based on observation and interview, several cat and other animal fecal droppings are in the childrens front play yard, which poses a health and safety 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:

Christina Gabelman

LICENSING EVALUATOR NAME:

Stephanie Li

LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: DEJONG FAMILY CHILD CARE	FACILITY NUMBER: 198012306
	VISIT DATE: 05/02/2024

NARRATIVE

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Licensing staff observed a swimming pool in the back yard and licensee states the children only use the pool during the summer with staff supervision. LPA(s) advised licensee to document swimming pool protocol that are being used during the summer. Pool fence and gate meet Title 22 regs and gate is self latching.

At 1:20pm, LPA observed the required 2A 10BC fire extinguisher with service tag indicating last service on 4/18/2023. LPA advised licensee that per State Fire Marshall standards that fire extinguishers shall be serviced annually and if self purchasing to keep the receipt with the fire extinguisher. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill was conducted in 1/19/24. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board in the classroom.

Currently, children are using the front yard and for outdoor play time. The outdoor play area was observed to be fenced. LPA’s observed the outdoor yard to have appropriate toys and other materials for children to use. LPA’s observed several feces droppings from cats and birds scattered across the front play yard ground and driveway, directly were the children play. This poses a health and safety danger to children in the outdoor yard. Citation is being issued, see page 809-D page. LPA’s also observed 2 cats from the garage having access into the front play yard via opened garage door and back side gate. Declaration received during visit from licensee stating she will eliminate cats access into the front yard to prevent them from dropping feces. Per licensee, she is having cleaning service come remove feces droppings from the front yard and will take photos and email them to LPA by 5/3/24.

At 2:30 pm, children and adult records were reviewed, including emergency information. All children enrolled between the ages 0-24months do not have a current 15 minute sleep check log. LPA’s advised licensee and staff that children between the ages 0-2yrs need to have a physical sleep check log. Per assistant, Janet, she is completing the safe sleep check every 15 minutes but wasn’t logging it. LPA’s provided sample sleep charts for licensee to begin immediate use.

The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee Pediatric First Aid and CPR expired on 2/19/26 . There are first aid supplies available. Licensee has completed the Mandated Reporter AB 1207 Training Certificate expiration date 1/09/26.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: DEJONG FAMILY CHILD CARE	FACILITY NUMBER: 198012306
	VISIT DATE: 05/02/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Safe sleep brochure provided for review.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Megan’s Law - Family Child Care Homes During the exit interview, the Licensee Aida Dejong, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee 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

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: DEJONG FAMILY CHILD CARE	FACILITY NUMBER: 198012306
	VISIT DATE: 05/02/2024

NARRATIVE

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Based on Licensing staff observations, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

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

Exit interview conducted, report, and appeal rights were reviewed with Licensee Aida Dejong.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

LIC809 (FAS) - (06/04)

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