<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191597108
Report Date: 04/25/2024
Date Signed: 04/26/2024 02:42:17 PM

Document Has Been Signed on 04/26/2024 02:42 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-BRIGHTWOODFACILITY NUMBER:
191597108
ADMINISTRATOR/
DIRECTOR:		NATHANIEL GUTIERREZFACILITY TYPE:
840
ADDRESS:1701 BRIGHTWOODTELEPHONE:
(818) 261-9818
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91754
CAPACITY: 40TOTAL ENROLLED CHILDREN: 17CENSUS: 9DATE:
04/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Kelly Quach, Site DirectorTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 04/26/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted. LPA met with Kelly Quach, Site Director and explained the purpose of the visit. LPA observed 9 children with 2 staff members.

The purpose of the visit is to follow up on an incident that occurred on 04/10/2024 and was reported to the department on 04/17/2024. The self reported incident is regarding supervision and personal rights.

During today's inspection, LPA interviewed Staff #1 (S1), Staff #2 (S2) and Child #1 (C1)

Based on interviews with S1, S2 and C1, there were no corroborating information to determine that a supervision or personal rights violation occurred. The facility is not being cited any deficiencies today.

An exit interview was conducted and a copy of this report was provided to the Site Director.

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: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1