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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019509
Report Date: 08/04/2026
Date Signed: 08/04/2026 12:28:39 PM

Document Has Been Signed on 08/04/2026 12:28 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 FOR LEARNING EAGLE ROCKFACILITY NUMBER:
198019509
ADMINISTRATOR/
DIRECTOR:		MILDRED BALDERRAMAFACILITY TYPE:
850
ADDRESS:4824 EAGLE ROCK BLVDTELEPHONE:
(626) 206-0734
CITY:LOS ANGELESSTATE: CAZIP CODE:
90041
CAPACITY: 73TOTAL ENROLLED CHILDREN: 73CENSUS: 24DATE:
08/04/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Lucy Baloshian - Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced Case Management inspection, to follow up on an incident reported to the Department on 07/29/2026. Upon arrival at 8:40am, LPA met with Facility Representative Lucy Baloshian, to whom the purpose of the inspection was explained. A tour of the facility was provided and census was taken. There were 24 children with 12 staff members.

On 07/28/2026, Parent #1 contacted the facility to inform them that Child #1 had received medical evaluation due to an bleeding injury that may have occurred at school, near the end of day. Parent #1 is concerned about if this did occur from another peer at school, and how it could have occurred. During today's inspection, LPA conducted interviews with two staff members, one child, and one parent. Documentation in the form of written statements was obtained.

During interviews, Staff #2 states that they are one of the closing staff members for Room 3 when Room joins the class for end of day. Per Staff #2, "It was usually me and [Staff #4], we walk around and sit with the children and interact. The last week I was not here so i am not sure who was with [Staff #4]. Child #1 (C1) was interviewed during today's inspection. C1 disclosed that they did visit a doctor due to an injury they had. C1 mentioned Child #2 during their interview when asked about the injury, but was not able to explain or elaborate how they became injured and how C2 was involved. Child #2 was not present for interview. Parent #1 (P1) was contacted via telephone. They disclosed that C1 would not explain who did it when asked if it was friends from school. P1 states that C1 told them "sticks" were what caused the bleeding. Parent #1 was able to share names of some of C1's friends at school, and C2 was mentioned. Parent #1 says that the facility mentioned C1 was trying hard in the restroom the days leading up to the incident, which could have been constipation. Staff #1 mentioned that they noticed C1 was taking a while in the restroom for 10-15 minutes around the date of incident. REPORT CONTINUES PAGE 1 of 2

Ana Chico
Nolan Tcheng
DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 FOR LEARNING EAGLE ROCK
FACILITY NUMBER: 198019509
VISIT DATE: 08/04/2026
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As of the date of inspection, Staff #3, #4, and #5, who were the staff for Room 1 and supervised Child #1 during the date of reported incident, are no longer assigned to the above facility. Interviews were not able to be conducted on this date. LPA review written statement, from Staff #3, who stated that children are not allowed to play with sticks at school and when staff observe children playing with them, the children are asked to throw it in the trash. The statement mentions that they are not really "sticks" because they are very flimsy and bendable. Incident will need further follow up.

At this time, no deficiencies are being cited in accordance with Title 22 regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Facility Representative Lucy Baloshian, at 12:30pm. Copy of Report provided.

END OF REPORT PAGE 2 of 2

NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Nolan Tcheng
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
LIC809 (FAS) - (06/04)
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