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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191599772
Report Date: 05/24/2024
Date Signed: 05/24/2024 11:50:20 AM


Document Has Been Signed on 05/24/2024 11:50 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-HEAD START-CHARTER OAKFACILITY NUMBER:
191599772
ADMINISTRATOR:ANTIONETTE BUSTAMANTEFACILITY TYPE:
850
ADDRESS:4949 BONNIE COVETELEPHONE:
(626) 967-1775
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY:24CENSUS: 7DATE:
05/24/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Alma Cordova, TeacherTIME COMPLETED:
12:05 PM
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On 05/24/2024, Licensing Program Analysts (LPAs) Kruz Long and Priscilla Ochoa conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted prior to entering the facility. LPAs met with Alma Cordova, Teacher and explained the purpose of the visit. LPAs observed 7 children with 3 staff member in the classroom. Linda Dagne, Education Supervisor arrived a short time later and assisted with the visit.

The purpose of the visit is to follow up on an incident that occurred on 05/14/2024 and was reported to the department on 05/15/2024 (reported timely). The self reported incident is regarding personal rights.

During this visit, LPAs obtained a copy of the children roster, interviewed Staff #1 (S1) to Staff #3 (S). LPAs attempted the interview Child #1 (C1) and interviewed Child #2 (C2).

There are no deficiencies being cited today as the incident requires further investigation.

An exit interview was conducted and a copy of this report and appeal rights was provided to the Education Supervisor. A Notice of Site Visit was provided; Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2024
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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