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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191597530
Report Date: 08/31/2022
Date Signed: 08/31/2022 10:26:36 AM

Document Has Been Signed on 08/31/2022 10:26 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-STATE PRESCHOOL-RAMONAFACILITY NUMBER:
191597530
ADMINISTRATOR:DEBORAH SLOBOJANFACILITY TYPE:
850
ADDRESS:509 WEST NORWOODTELEPHONE:
(818) 289-9792
CITY:ALHAMBRASTATE: CAZIP CODE:
91803
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 16DATE:
08/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Teacher, Rachel GomezTIME COMPLETED:
10:35 AM
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An unannounced annual site inspection was conducted by Licensing Program Analyst (LPA), Bardo Baluyot, who met with Teacher, Rachel Gomez. LPA conducted a COVID risk self-assessment upon entry. Program operates from 8:45am to 11:45am.

LPA observed 4 staff with 16 children. 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.

Bungalow was identified on facility sketch and inspected. 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 jugs and disposable cups.

Outdoor area and equipment was inspected for safety, cushioning material, condition and age appropriateness. Required shade and fencing were inspected. Outdoor drinking water is provided in form of water jug and disposable cups. 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 completeness.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2022
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-STATE PRESCHOOL-RAMONA
FACILITY NUMBER: 191597530
VISIT DATE: 08/31/2022
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

No deficiencies were cited during today's inspection in accordance with Title 22 California Code of Regulations.

No children or staff files were reviewed during today's inspection. Files are kept in Options State Preschool's main office located at: 18455 E. Railroad St. City of Industry, CA 91748. Tel # (626) 854-3449

Exit interview conducted and report was reviewed with Teacher Rachel Gomez


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.

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



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/inspection-process.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
LIC809 (FAS) - (06/04)
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