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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191599772
Report Date: 06/21/2024
Date Signed: 06/21/2024 09:16:51 AM

Document Has Been Signed on 06/21/2024 09:16 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/
DIRECTOR:		ANTIONETTE BUSTAMANTEFACILITY TYPE:
850
ADDRESS:4949 BONNIE COVETELEPHONE:
(626) 967-1775
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY: 24TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
06/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Mabel Nunez, Associate TeacherTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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On 06/21/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management visit for the purpose of following up on an unusual incident that occurred on 05/14/2024 and was reported to the department on 05/15/2024 (reported timely). A COVID-19 risk assessment was conducted. LPA met with Mabel Nunez, Associate Teacher and explained the purpose of the visit. LPA observed 10 children with 3 staff members in the classroom.

LPA conducted interviews with facility staff, children, and parents. At this time, it has been determined that no deficiencies are being cited in accordance to Title 22 California Code of Regulations.

An exit interview was conducted and a copy of this report and appeal rights was provided to Mabel Nunez, Associate Teacher. A Notice of Site Visit was also provided. Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2024
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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