198020478-5-11-2020-33-CC-ACAS-BPHSD4-20200511134630

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020478
Report Date: 05/11/2020
Date Signed: 05/11/2020 01:47:00 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 FOR LEARNING SURROUND CARE-MAYBROOK		FACILITY NUMBER:	198020478
ADMINISTRATOR:	LORINDA PACHECO		FACILITY TYPE:	840
ADDRESS:	11700 MAYBROOK AVE		TELEPHONE:	(626) 260-3953
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90604
CAPACITY:	37	CENSUS: 0	DATE:	05/11/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Linda Romero		TIME COMPLETED:	01:41 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	This was a pre-licensing inspection conducted by Licensing Program Analyst (LPA) Ariel Cazares due to COVID-19 and precautionary measures. This prelicensing inspection for a change of location application that was conducted with Education Coordinator Linda Romero via a tele-inspection by use of FaceTime and Rosemary Olachea-Heaslip Division Director via conference call. This facility will operate a morning and afternoon session from 6:30am-8:30am and 2-6pm. During non-school days hours will be 6:30-6pm. The facility consists of a portable that was identified on the facility sketch and inspected. The facility operates on Maybrook Elementary School through Options for Learning. 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 observed. The condition and age appropriateness of children’s sinks and toilets were inspected. The restrooms allow for individual privacy. LPA evaluated general sanitation and cleanliness of facility. Availability of indoor drinking water was observed in form of water fountains attached to sinks. Carbon Monoxide/Smoke combination detector was tested and functioning. Snack/lunch menu was observed posted on the parent board near the entrance. A review of cleaning supplies was done and observed in the staff restroom in locked cabinet. First aid supplies are kept in a locked cabinet where medication will also be kept. Outdoor area was inspected for safety. There are large trees located near the portable that provide shade and benched tables are available for rest. Play area was inspected for hazards and inaccessibility to bodies of water. Outdoor drinking water will be provided in form of water jug and cups.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020

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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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 FOR LEARNING SURROUND CARE-MAYBROOK	FACILITY NUMBER: 198020478
	VISIT DATE: 05/11/2020

NARRATIVE

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LPA did not observe any hazards or need for repair. The facility is in compliance and application complete. A fire clearance is on file. Although a capacity of 37 was initially requested, a capacity of 35 can be granted based on the fire clearance. Program is exempt from square-footage requirement. Documentation is on file.

Exit interview was conducted with staff via telephone, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Applicant/Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Applicants/Licensee’s signature.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020

LIC809 (FAS) - (06/04)

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