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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001139
Report Date: 01/17/2020
Date Signed: 01/17/2020 12:53:26 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: 29DATE:
01/17/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Alma CamposTIME COMPLETED:
11:35 AM
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Licensing Program Analysts (LPAs) Ariel Cazares and Bardo Baluyot conducted a case management inspection on this date. LPAs met with Site Director Alma Campos. LPAs toured the facility. There are two portables on site: State Preschool and Full Day.

LPAs conducted today's inspection for the purpose of following up on an incident that was reported to the Department on 12/17/19. At this time the staff present during the incident were not available for interviews. Child #1 was interviewed.

At this time additional information is needed prior to determining whether or not a violation occurred.

Exit interview was conducted with Site Supervisor Alma Campos. A copy of this report was provided.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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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