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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017688
Report Date: 06/21/2022
Date Signed: 06/21/2022 12:38:57 PM

Document Has Been Signed on 06/21/2022 12:38 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:OPTIONS-HEAD START/CDC-ORANGE GROVEFACILITY NUMBER:
198017688
ADMINISTRATOR:EVANGELINA PADILLAFACILITY TYPE:
850
ADDRESS:595 N. LINCOLN AVENUETELEPHONE:
(626) 206-0730
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 12DATE:
06/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Site Director, Alma CamposTIME COMPLETED:
01:00 PM
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An unannounced Required Annual site inspection was conducted by Licensing Program Analyst (LPA), Bardo Baluyot, who met with Site Director, Alma Campos who provided a tour of the facility. LPA observe 12 children present with 3 staff in classroom #5. This facility operates both a Head Start and full day preschool program. Hours vary from 7:15-4:30 for the Head Start program and 7:30am-4:30pm for the full day.

LPA observed 11 staff with 46 children in total. LPA found that facility is within ratio. Care and supervision was evaluated to determine if the basic needs of children are met. LPA observed during this inspection that facility is in compliance of this. LPA reviewed sign in/outs sheets and children's roster for all classrooms (#1-5).

Furniture and equipment were inspected for age appropriateness and its condition. Telephone service, heating, lighting and ventilation were evaluated. Storage space/area for children's belongings was inspected. The condition and age appropriateness of children’s sinks and toilets were inspected. LPA evaluated general sanitation and cleanliness of facility. Availability of indoor drinking water was observed in form of water jug with disposable cups.

Outdoor area and equipment was inspected for safety, cushioning material, condition and age appropriateness. Required shade, drinking water and fencing were inspected. Play area was inspected for hazards and inaccessibility to bodies of water.

Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation area was inspected. A review of cleaning and food supply storage areas was made. LPA inspected First Aid kit’s supplies and found it to be adequate.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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-HEAD START/CDC-ORANGE GROVE
FACILITY NUMBER: 198017688
VISIT DATE: 06/21/2022
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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
Per Site Director, there are no children with IMS currently.

Children and staff files are kept in the main office: Options State Preschool's main office, located at: 464 Woodbury Rd. #210, Altadena CA 91001 (626)204-8900



Site Director 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.

INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22 Regulations.



After a complete inspection of the facility, there were no deficiencies observed on this date according to California Code of Regulations Title 22 Division 12.

Exit interview conducted and report was reviewed with the Site Director, Alma Campos.


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.

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/process.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
LIC809 (FAS) - (06/04)
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