198003377-6-29-2022-33-CC-BBAT-CFURFN-20220629125925

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003377
Report Date: 06/29/2022
Date Signed: 06/29/2022 12:59:35 PM

Document Has Been Signed on 06/29/2022 12:59 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	OPTIONS SURROUND CARE-WASHINGTON		FACILITY NUMBER:	198003377
ADMINISTRATOR:	DARLA VILLARUEL		FACILITY TYPE:	840
ADDRESS:	300 N. SAN MARINO		TELEPHONE:	(818) 282-1223
CITY:	SAN GABRIEL	STATE: CA	ZIP CODE:	91775
CAPACITY:	40	CENSUS: 20	DATE:	06/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:28 AM
MET WITH:	Linda Garcia, Site Director		TIME COMPLETED:	01:15 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	An unannounced annual site inspection was conducted by Licensing Program Analyst (LPA), Bardo Baluyot, who met with Site Director, Linda Garcia. Associate Teacher, Amanda Martinez was also present during the inspection. LPA conducted a COVID risk self assessment upon entry. This facility is in summer session and operates from 6:30am-6:30pm. LPA observed 2 staff with 8 children upon arrival. Throughout the visit other children arrived bringing census to 20 at one point. LPA found that facility is within ratio. Care and supervision was evaluated to determine if the basic needs of children are met. LPA observed during this inspection that facility is in compliance of this. LPA reviewed sign in/outs sheets and children's roster. Bungalow was identified on facility sketch and inspected. Furniture and equipment were inspected for age appropriateness and its condition. Telephone service, heating, lighting and ventilation were evaluated. Storage space/area for children's belongings was inspected. The condition and age appropriateness of children’s sinks and toilets (located by the office and shared with the school) were inspected. LPA evaluated general sanitation and cleanliness of facility. Availability of indoor drinking water was observed in form of a water jug and disposable cups. Outdoor area and equipment was inspected for safety, cushioning material, condition and age appropriateness. Required shade and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Water is provided in form of water jug and disposable cups. Snack menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation area was inspected. A review of cleaning and food supply storage areas was made. LPA inspected First Aid kit’s supplies and completeness.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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-WASHINGTON	FACILITY NUMBER: 198003377
	VISIT DATE: 06/29/2022

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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
Per Director, there are two children with IMS currently but will not be attending until late July. LPA reviewed children's epi-pen and inhaler and found them to be within their expiration dates and physician's information, parent authorization and instructions were available.

No children or staff files were reviewed during this inspection. Children and staff files are kept in the main office: Options Surround Care's main office, located at: 304 S. 1st St. Alhambra, CA 91801 (626)284-9935.

No deficiencies were cited during today's inspection.

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.

Exit interview conducted and report was reviewed with the Site Director, Linda Garcia.

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: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

LIC809 (FAS) - (06/04)

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