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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014553
Report Date: 08/01/2024
Date Signed: 08/01/2024 01:48:42 PM

Document Has Been Signed on 08/01/2024 01:48 PM - 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 CDC - ROOSEVELTFACILITY NUMBER:
198014553
ADMINISTRATOR/
DIRECTOR:		ROCIO ARROYOFACILITY TYPE:
850
ADDRESS:5356 DELTA AVENUETELEPHONE:
(626) 858-0527
CITY:SAN GABRIELSTATE: CAZIP CODE:
91776
CAPACITY: 48TOTAL ENROLLED CHILDREN: 35CENSUS: 25DATE:
08/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Merwin Caiza Rodriguez, Education SupervisorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 08/01/2024, Licensing Program Analysts (LPAs) Kruz Long and Pricilla Ochoa conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted. LPAs met with Merwin Caiza Rodriguez, Education Supervisor and explained the purpose of the visit. There are currently 35 children enrolled. LPAs observed: Classroom #1 (12 children and 3 Staff), Classroom #2 (13 children and 4 staff).

The purpose of the visit is to follow up on an incident that occurred on 07/24/2024 and was reported to the department on 07/29/2024. The self reported incident is regarding personal rights.

During this inspection LPAs obtained a copy of the Children roster, interviewed Staff #1 (S1) to Staff #3 (S3) and attempted to interview Child #1 (C1).

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.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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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