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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001139
Report Date: 05/31/2019
Date Signed: 05/31/2019 02:09:05 PM

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-STATE PRESCHOOL-LOS ALTOSFACILITY NUMBER:
198001139
ADMINISTRATOR:DEBORAH SLOBOJANFACILITY TYPE:
850
ADDRESS:14047 TEDFORD ST.TELEPHONE:
(310) 906-0891
CITY:SOUTH WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY:48CENSUS: 14DATE:
05/31/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:48 PM
MET WITH:Irma OsorioTIME COMPLETED:
02:30 PM
NARRATIVE
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Ana Chico, Licensing Program Analyst (LPA) conducted an unannounced Case Management Inspection. LPA met with Irma Osorio, Site Director. LPA also conducted a phone interview with Lina Rodriguez, Education Coordinator.

According to staff interviewed, there were four cases of lice at the facility which was not reported to the licensing department between March 1st and March 8th. Per staff, precautions were taken to stop the spread of lice, however, they were unaware that the incident would fall under the department's requirement to report the incident to the licensing office. Based on staff's own submission of the above event, licensee is being cited for failing to report incident(s) pertaining to multiple cases of lice.

Exit interview conducted. A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty. *****See 809D for deficiency cited.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
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-STATE PRESCHOOL-LOS ALTOS
FACILITY NUMBER: 198001139
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/07/2019
Section Cited
CCR
101212(d)
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Reporting Requirements:
Upon the occurrence, during the operation of the child care center of any of the events specified a report shall be made to the Department by telephone or
fax within the Department's next working day and during its normal business hours. In addition, a written report containing the
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Staff stated that an unusual incident report will be received by POC date.
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 information specified shall be submitted to the Department within seven days following the occurrence of such event. This requirement is not being met as evidenced by staff's own submission that they failed to notify the Department of an unusual incident involving multiple cases of lice. This poses a potential risk to the health and safety of children in care.
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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.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
LIC809 (FAS) - (06/04)
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