191595236-10-13-2022-33-CC-BBAT-CK6PU8-20221013113708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191595236
Report Date: 10/13/2022
Date Signed: 10/13/2022 11:37:14 AM

Document Has Been Signed on 10/13/2022 11:37 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	OPTIONS-SURROUND CARE-NEW TEMPLE		FACILITY NUMBER:	191595236
ADMINISTRATOR:	IRENE VALDIVIA		FACILITY TYPE:	840
ADDRESS:	11033 E. CENTRAL AVE.		TELEPHONE:	(626) 350-9677
CITY:	SOUTH EL MONTE	STATE: CA	ZIP CODE:	91733
CAPACITY:	28	CENSUS: 0	DATE:	10/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Teacher, Maria Aguilar		TIME COMPLETED:	11:36 AM

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	Licensing Program Analyst (LPA), Bardo Baluyot conducted a Required Annual random inspection. Upon arrival LPA met with Head Start teacher, Maria Aguilar. LPA conducted a COVID risk self-assessment upon entry. There were no children present during today's inspection. Per Ms. Aguilar, the program is not currently operating due to low enrollment but portable will be shared with the adjacent Head Start program from 8:45-12:15 PM once licensed. This program operates on the campus of New Temple Elementary School (K-4th). Children from neighboring school, Shively Middle School (5th-8th), also attend the program. According to staff, those attending Shively, walk to New Temple by foot with staff. In addition to Surround Care's School Age, there is also an Options Head Start program on site. Options Surround Care offers before and after school care. The schedule is as follows: 6:30 AM - 8:30 AM and 1PM - 6PM Monday -Friday. Children attending the before and after school program use one of two portables on site. The portable is adjacent to the elementary school. Furniture and equipment were inspected for age appropriateness and good repair. The room is well ventilated via central air. The refrigerator, microwave and electric oven were observed to be clean. Carpeting and flooring were also observed to be well maintained. Availability of drinking water is provided via water fountains. First Aid supplies are maintained on site. Cleaning solutions are stored inside a locked cabinets. Children have cubbies and/ or hooks to store their personal items in. A variety of games and other learning materials are available. Restrooms for children is located inside the adjacent Head Start classroom. Emergency Disaster Drill log is kept. Ms. Aguilar's First Aid/ CPR were reviewed and expire 7/20/24. Sign in and out sheets and procedures were reviewed. Per Ms. Aguilar, children are signed in by parents or staff upon arrival and children attending the elementary school in the after noon are singed in by staff. PAGE 1 OF 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: OPTIONS-SURROUND CARE-NEW TEMPLE	FACILITY NUMBER: 191595236
	VISIT DATE: 10/13/2022

NARRATIVE

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The playground is shared between Head Start and Surround Care programs. Per Ms. Aguilar, both programs adhere to a staggered schedule when using the playground and avoid co-mingling of different age groups. The playground includes hard yard and grassy areas where attendees can engage in sports and social play. There is a climbing structure which appeared to be well anchored and is surrounded by rubber padding to absorb falls. There is also a sandbox which is covered when not in use. Pitcher and cups are taken outdoors to ensure that children are provided with water freely and as they wish.

Menus were reviewed for availability, quantity and appropriateness to children in care. The program offers an afternoon snack. Snacks are provided by Options Food Program which follow mandated Federal Food Guidelines. Meal menus, license, car seat law, parents' rights for centers, emergency disaster plan and all other posting requirements were observed.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

No deficiencies cited during today's visit in accordance with Title 22 California Code of Regulations.
All clearances are associated to the Granada Administrative File #191592096.
No children or staff files were reviewed during today's visit. Files are kept in the
Options State Preschool's main office located at: 304 South 1st St. Alhambra 91801 Telephone # (626) 284-9935

Exit interview conducted and report was reviewed with Teacher, Maria Aguilar

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: OPTIONS-SURROUND CARE-NEW TEMPLE	FACILITY NUMBER: 191595236
	VISIT DATE: 10/13/2022

NARRATIVE

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INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22 Regulations.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

LIC809 (FAS) - (06/04)

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