198006849-9-28-2022-33-CC-BBAT-CJPNJ6-20220928102951

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198006849
Report Date: 09/28/2022
Date Signed: 09/28/2022 10:29:59 AM

Document Has Been Signed on 09/28/2022 10:29 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-STATE PRESCHOOL-KILLIAN		FACILITY NUMBER:	198006849
ADMINISTRATOR:	DEBORAH SLOBOJAN		FACILITY TYPE:	850
ADDRESS:	19120 KILLIAN		TELEPHONE:	(626) 581-8813
CITY:	ROWLAND HEIGHTS	STATE: CA	ZIP CODE:	91748
CAPACITY:	24	CENSUS: 20	DATE:	09/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Teacher, Lynn Du		TIME COMPLETED:	10:40 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	An unannounced Required Annual site inspection was conducted by Licensing Program Analyst (LPA), Bardo Baluyot who met with Teacher, Lynn Du who guided analyst on a complete tour of the facility. Program currently operates from 8 AM to 12 PM. There were 20 children and 3 staff present during the visit. Education Coordinator, Marie Cruz arrived a short time later and was observed assisting with the children. Options Head Start program shares the bungalow and operates an afternoon session from 12:30-4PM. There is another bungalow on the property that is licensed with Options Surround Care. Rooms identified on facility sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and an isolation area with a sink, toilet were inspected. Age appropriate sinks and toilets were inspected for availability and good repair. General sanitation was observed. Availability of indoor drinking water was observed. Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water. Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness. A review of cleaning and food supply storage areas was made. First Aid supplies were inventoried. Ms. Du's CPR/First Aid certifications were reviewed and expire 8/16/2024.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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-STATE PRESCHOOL-KILLIAN	FACILITY NUMBER: 198006849
	VISIT DATE: 09/28/2022

NARRATIVE

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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

Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met.

After a complete inspection of the facility, there were no deficiencies observed on this date according to California Code of Regulations Title 22 Division 12.

No staff or children's files were reviewed during today's visit. Files are stored at the Options State Preschool's main office located at: 18455 E. Railroad St. City of Industry, CA. 91748
Tel # (626)854-3449

Exit interview conducted and report was reviewed with Teacher, Lynn Du.

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.

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

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/inspection-process.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC809 (FAS) - (06/04)

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