191597000-10-2-2024-33-CC-POCA-D9NPBF-20241002111016

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191597000
Report Date: 09/26/2024
Date Signed: 10/02/2024 11:14:56 AM

Document Has Been Signed on 10/02/2024 11:14 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	OPTIONS-SURROUND CARE-HOLLINGWORTH SCHOOL AGE		FACILITY NUMBER:	191597000
ADMINISTRATOR/ DIRECTOR:	RACHEL SILVA		FACILITY TYPE:	840
ADDRESS:	3005 E. HOLLINGWORTH STREET		TELEPHONE:	(818) 284-9935
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91792
CAPACITY: 120	TOTAL ENROLLED CHILDREN: 16	CENSUS: 9	DATE:	09/26/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Lead Teacher, Noemi Paez		TIME VISIT/ INSPECTION COMPLETED:	03:35 PM

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On September 26, 2024, Licensing Program Analysts (LPAs) Priscilla Ochoa and Kruz Long conducted an unannounced annual inspection. A COVID-19 risk assessment was conducted prior to entering the facility. LPAs met with Lead Teacher, Noemi Paez, who guided the LPA on a tour of the facility. This is a school age program that operates on Hollingsworth Elementary School Campus. The bungalow is located near the front of the school in Bungalow 1. The program operates Monday through Friday from 6:30 am – 8 am and 1:30 pm - 6 pm. Per Lead Teacher there are 16 children enrolled in the program. LPAs observed 9 children in care.

The program consists of 1 classroom. The following classroom were inspected: Classroom 1: 9 children with 1 lead teacher. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision. Licensed facility is within the conditions, limitations, and capacity specified on the license.

The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Storage for children's belongings were inspected. All toilets and washing facilities are in safe and sanitary operating conditions. First Aid supplies are available and complete. Drinking water was readily available indoors. All materials and surfaces accessible to children are toxic free.

At this time, the reading area is being used as an isolation area when a child becomes ill. A mat is available for child in care if needed.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OPTIONS-SURROUND CARE-HOLLINGWORTH SCHOOL AGE	FACILITY NUMBER: 191597000
	VISIT DATE: 09/26/2024

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The facility provides snacks and filtered water to children in care. Children in care bring their own water bottles but the facility provides filtered water as well. The cabinet at the far back end of the classroom is where snacks are stored and observed to be clean and cleaning compounds/solutions were found to be stored away from the food.

LPAs observed a working smoke/carbon monoxide detector in the facility. LPAs observed a fully charged and serviced fire extinguisher that was serviced on 7/15/2024. Emergency disaster drill was last conducted on 09/25/2024.

Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Parents sign in their child via QR code that is located in front of the classroom door. Then the sign ins are recorded in the HUBBE.

Children’s Records were reviewed through the HUBBE to ensure that Identification and Emergency form and a medical assessment are on file. LPA reviewed staff records through Paylocity. Child and staff record were found to be complete. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Lead Teacher. The Lead Teacher and staff do currently have immunization documentation.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OPTIONS-SURROUND CARE-HOLLINGWORTH SCHOOL AGE	FACILITY NUMBER: 191597000
	VISIT DATE: 09/26/2024

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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

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP

LPA advised the Lead Teacher to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Lead teacher was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Lead Teacher was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OPTIONS-SURROUND CARE-HOLLINGWORTH SCHOOL AGE	FACILITY NUMBER: 191597000
	VISIT DATE: 09/26/2024

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At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no deficiencies being cited today, September 26, 2024.

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of the report was provided, along with appeal rights to Lead Teacher, Noemi Paez.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC809 (FAS) - (06/04)

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