191500006-6-28-2023-33-CC-JHUA-CT8P5V-20230628110123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500006
Report Date: 06/28/2023
Date Signed: 06/28/2023 11:01:28 AM

Document Has Been Signed on 06/28/2023 11:01 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	OPTIONS SURROUND CARE-BLANDFORD		FACILITY NUMBER:	191500006
ADMINISTRATOR:	BERTHA SEQUEIDA		FACILITY TYPE:	840
ADDRESS:	18605 LINCROFT STREET		TELEPHONE:	(626) 913-0603
CITY:	ROWLAND HEIGHTS	STATE: CA	ZIP CODE:	91748
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 51	CENSUS: 16	DATE:	06/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Araceli Rangel & Aurora Del Campo		TIME COMPLETED:	11:05 AM

NARRATIVE

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Licensing Program Analyst (LPA) Jennifer Hua conducted an unannounced 1-year required inspection at the above facility on 06/28/23 at 08:40AM. A COVID risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Araceli Rangel, Substitute teacher, Roberta Malone, T.A and Marisa Stansbury, T.A Sub. Teacher Rangel, left at around 9:07Am and when teacher Aurora Del Campo arrived. LPA observed 16 children present. There were 13 children present when LPA arrived, more children arrived during visit. The program operates on the campus of Blandford Elementary School. Options Surround Care offers before and after school care. The schedule is as follows: 6:30 AM - 6:00 PM.

At this time the program uses portable to house the children attending the before and after school program. Furniture and equipment were inspected for age appropriateness and good repair. The room is well ventilated via central air. Carpeting and flooring were observed to be clean. Availability of drinking water was also observed via water jugs with paper cups. First Aid supplies are on the premises. Carbon monoxide/smoke detector in the classroom. Cleaning solutions are stored inside a locked cabinet. LPA observed a variety of games and other learning materials available for children. Children have cubbies to store their personal items in. Staff escorts children to restrooms which are located outdoors.

The outdoor play yard used is directly outside the portable. Play equipment are brought out, Children only use the cement area outside. Teachers take water jug with cups when outdoors. Shade is provided via adjacent structures.

Roster was available and up to date. An Emergency Disaster Drill log is kept and it is posted. .The program conducts routine emergency drills (last recorded 06/20/23). Sign in and out sheets and procedures were reviewed. Children are signed in electronically. Individual PIN # are provided to each family member. Children attending the elementary school are signed in by staff during school days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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 SURROUND CARE-BLANDFORD	FACILITY NUMBER: 191500006
	VISIT DATE: 06/28/2023

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Menus were reviewed for availability, quantity, and appropriateness to children in care. The morning program offers breakfast only when school is not in session, Morning and afternoon snacks are provided when children are present full day. Children bring their own lunch. Snacks are provided by Options Food Program which follow mandated Federal Food Guidelines and are delivered twice a week. Meal menus, license, car seat law, parents' rights for centers, emergency disaster plan and all other posting requirements were observed.

This facility provides Incidental Medical Services – IMS. There is currently (2) child receiving IMS services. All medications were checked for expiration dates and were current. 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.

All clearances are associated to the Granada Administrative File #191592096. Mandated Reporter Training Certificate and new immunization requirements are also a requirement for hire. More information can be found at: http:/www.mandatedreporterca.com/training /training.htm. All licensed providers, applicants, directors, and employees are required to complete training as specified on the mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Please review all elements outlined in AB 1207- Mandated Reporting Training.

Per waiver agreement on file for Options, employee and children's records will be reviewed during a collateral inspection at the Alhambra, CA headquarters.

DEFICIENCY CITED IN ACCORDANCE TO TITLE 22 CALIFORNIA CODE OF REGULATIONS on attached 809D.

Upon receipt, the Licensee shall post the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posted as required will result in a $100 civil penalty.

An exit interview was conducted with Aurora Del Campo, and a copy of this report has been signed by and provided. Appeal rights were also provided.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/28/2023 11:01 AM - It Cannot Be Edited

Created By: Jennifer Hua On 06/28/2023 at 10:33 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OPTIONS SURROUND CARE-BLANDFORD	FACILITY NUMBER: 191500006
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/28/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, the licensee did not comply with the section cited above in outlet from the elementary school kitchen cafeteria is use to obtain drinking water has not been tested as required, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/28/2023
	Plan of Correction
1 2 3 4	Per licensee, will correct and submit all required documents to LPA by the POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Ana Chico

LICENSING EVALUATOR NAME:

Jennifer Hua

LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

LIC809 (FAS) - (06/04)

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