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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191595710
Report Date: 12/03/2024
Date Signed: 12/03/2024 04:45:30 PM

Document Has Been Signed on 12/03/2024 04:45 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 SURROUND CARE-OSWALTFACILITY NUMBER:
191595710
ADMINISTRATOR/
DIRECTOR:
DOLORAS MARTINEZFACILITY TYPE:
840
ADDRESS:19501 SHADOW OAK DR.TELEPHONE:
(626) 964-7358
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 17DATE:
12/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Promila Sawhney - Lead TeacherTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced Case Management-Incident inspection, to follow up on an incident reported to the Department on 11/21/2024. Upon arrival at 3pm, LPA met with Lead Teacher Promila Sawhney, to whom the purpose of the inspection was explained. A tour of the facility was provided . There were children present during the inspection.

Census was taken. There were 17 children with 2 staff members.

On 11/18/2024, an incident took place at the facility that was a potential violation of a child's personal rights. According to Child #1, they told their authorized representative that Staff #2 aggressively grabbed them. No injuries or medical evaluation took place. On today's inspection, interviews were conducted with persons involved in the reported incident. During today's inspection, LPA confirmed that Staff #2 has worked here for about 3 weeks and has no previous history. During interview with Child #1, they physically indicated which staff member was involved but incorrectly named the Staff member during interview.

There were conflicting statements from the persons interviewed. Based on the information collected during this inspection, there is not enough preponderance of evidence to prove a violation of Personal Rights took place. Therefore, no deficiencies are being cited on this date.

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

Exit interview conducted and report was reviewed with Lead Teacher Promila Sawhney, at 4:45pm. Copy of Report provided.

END OF REPORT

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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