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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400263
Report Date: 04/22/2026
Date Signed: 04/22/2026 03:16:53 PM

Document Has Been Signed on 04/22/2026 03:16 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:DORLUS FAMILY CHILD CAREFACILITY NUMBER:
198400263
ADMINISTRATOR/
DIRECTOR:		JESSIEKA DORLUSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 872-2712
CITY:LOS ANGELESSTATE: CAZIP CODE:
90001
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
04/22/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Jessieka Dorlus, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of a Case Management - Other inspection. LPA White announced the purpose of the visit and was granted entry into the facility by Licensee Jessieka Dorlus. There are 7 children enrolled and 6 children present at the time of the inspection. All staff have current criminal background clearance.

The purpose of today's visit is to review the plans Licensee has for the remodeling of her back yard including an Accessory Dwelling Unit (ADU). Licensee states that permits have been acquired through the city, and construction is set to begin tentatively for May 4, 2026. Licensee states that the end date for all construction work, and final permits to be obtained in September. Licensee states that the ADU will be used as the main care space for the child care.

At 2:30 p.m., LPA White informed Licensee Jessieka Dorlus that the following documents would be needed in order to fullfill the Reporting Requirement according to California Title 22 Regulation:
  • LIC 279 A - Check change of location for the ADU to be used as the main space for the day care.
  • LIC 624 - Unusual Incident Report - to inform the department on the official start date of construction work, and modifications to the entrance and exits of the home for children and parents during drop off and pick up time.
  • LIC 999 - Facility Sketch - (indoor and door) - to label temporarily label the back yard as off limits during construction, and the front yard as the day care outdoor play area. To also label the temporary entrance and exit to the facility as the front door of the home, and make the living room and kitchen a space that children pass through to reach the day care space located at the rear of the home.
(Report continues 1 of 2 Pages
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2026
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: DORLUS FAMILY CHILD CARE
FACILITY NUMBER: 198400263
VISIT DATE: 04/22/2026
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  • Updated documents can be sent to the department during the construction process should more changes occur. All changes need to be submitted prior to implementing any changes.
LPA White reminded Licensee Jessieka Dorlus of the following:
  • the kitchen area needs to remain free of hazards such as knives being stored in a locked container out of reach of children in care.
  • The back door that leads to the back yard must remain locked during hours of operation.

Licensee provided an updated Emergency Disaster Plan reflective of new temporary locations. LPA White observed Licensee print and post a copy for parents to see during drop off and pick up.

Licensee states that the LIC 999, and 624 will be sent before May 4, 2026. LPA White informed Licensee that a visit will be conducted during construction, and at the completion of construction to ensure that the area meets the requirements for licensing.

Based on today's visit there will be no deficiencies cited in accordance with California Title 22 regulations.

A Notice of Site Visit was given to Licensee Jessieka Dorlus, and must remain posted for 30 days. Failure to post will result in a civil penalty of $100.

Report was reviewed with Licensee Dorlus. A copy of the report and appeal rights was given to Licensee Jessieka Dorlus.

(Report Ends Here 2 of 2 Pages).
NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC809 (FAS) - (06/04)
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