191500340-10-28-2022-33-CC-BBAT-CKMNMX-20221028103553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500340
Report Date: 10/28/2022
Date Signed: 10/28/2022 10:35:59 AM

Document Has Been Signed on 10/28/2022 10:35 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-NORTHAM		FACILITY NUMBER:	191500340
ADMINISTRATOR:	DEBORAH SLOBOJAN		FACILITY TYPE:	850
ADDRESS:	423 SHIPMAN		TELEPHONE:	(818) 913-1325
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 15	DATE:	10/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Teacher Sylvia Garcia		TIME COMPLETED:	09:45 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	Licensing Program Analyst (LPA), Bardo Baluyot conducted an unannounced Required Annual site inspection. Upon entry, LPA conducted a COVID risk-self assessment and met with Teacher, Sylvia Garcia. and Associate Teacher Adriana. Options State Preschool operates on the campus of Northam Elementary School. The program operates from 8AM-12PM (Monday -Friday). In addition to the State Preschool program, Options for Learning also operates an Options Head Start preschool program and an Options Surround Care School Age Program in adjacent bungalows. Each program operates separately. Children attending use the rear portable adjacent to the elementary school. Furniture and equipment were inspected for age appropriateness and good repair. The room is well ventilated via central air/ heat. Children were observed to be engaged in story time activities and art projects. The refrigerator, microwave and electric oven were observed to be clean. Carpeting and flooring were also observed to be clean and well maintained. A staff and children's restrooms are available inside the class room. Availability of drinking water is provided via water jug and disposable cups. Cleaning solutions are stored inside a cabinet and/or cabinets that are not accessible to children. Children have cubbies to store their personal items in. A variety of games and other learning materials are available. The preschool children use the main playground which is completely fenced with a five foot chain link fence. The State Preschool Program has additional fencing between portables. Children have access to a grassy area which is maintained and other playground equipment observed to be age appropriate. A water jug with cups are taken outdoors as a drinking source. Shade is provided via trees and a pergola area. First Aid supplies are kept in a backpack and were inventoried for quantity and expiration dates. Ms. Garcia's First Aid is current and expires on 11/13/2023. PAGE 1 OF 3

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022

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-NORTHAM	FACILITY NUMBER: 191500340
	VISIT DATE: 10/28/2022

NARRATIVE

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LPA observed 15 children with two staff. Per staff, there are currently 16 children enrolled. Two staff (Site Supervisor and Associate Teacher) are assigned at this site to ensure that teacher-child ratios are in compliance at all times. An additional floating staff is provided to provide breaks. Roster was available and up to date. An Emergency Disaster Drill log is kept. The program conducts routine emergency drills (last recorded 10/20/22). Per staff, a health check is conducted upon arrival. Sign in and out sheets and procedures were reviewed. Children are signed in by parents upon arrival. All children physically present were observed to be signed in.

Menus were reviewed for availability, quantity and appropriateness to children in care. The program offers one meal (breakfast) provided by Options Food Program which follows mandated Federal Food Guidelines. Meal menus, license, car seat law, parents' rights for centers, emergency disaster plan and all other posting requirements were observed.

Per staff, there are (0) children receiving IMS services at this time.
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

All clearances are associated to the Ynez Administrative File #191592586.

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

NO DEFICIENCIES ARE BEING CITED IN ACCORDANCE TO TITLE 22 CALIFORNIA CODE OF REGULATIONS.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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-NORTHAM	FACILITY NUMBER: 191500340
	VISIT DATE: 10/28/2022

NARRATIVE

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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 Teacher, Sylvia Garcia.

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.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022

LIC809 (FAS) - (06/04)

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