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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
198011947
Report Date:
08/26/2022
Date Signed:
08/26/2022 11:22:39 AM
COMPREHENSIVE INSPECTION
Document Has Been Signed on
08/26/2022 11:22 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-MULBERRY
FACILITY NUMBER:
198011947
ADMINISTRATOR:
DEBORAH SLOBOJAN
FACILITY TYPE:
850
ADDRESS:
14029 MULBERRY DR.
TELEPHONE:
(562) 699-2918
CITY:
WHITTIER
STATE:
CA
ZIP CODE:
90605
CAPACITY:
24
CENSUS:
DATE:
08/26/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
11:12 AM
MET WITH:
Inactive
TIME COMPLETED:
11:30 AM
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LPA attempted to conduct an unannounced Required Annual Inspection and found the Facility to be closed/inactive.
SUPERVISOR'S NAME:
Ana Chico
TELEPHONE:
(323) 981-3351
LICENSING EVALUATOR NAME:
Bardo Baluyot
TELEPHONE:
(323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE:
08/26/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/26/2022
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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