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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003377
Report Date: 08/08/2024
Date Signed: 08/08/2024 09:54:38 AM

Document Has Been Signed on 08/08/2024 09:54 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:OPTIONS SURROUND CARE-WASHINGTONFACILITY NUMBER:
198003377
ADMINISTRATOR/
DIRECTOR:		DARLA VILLARUELFACILITY TYPE:
840
ADDRESS:300 N. SAN MARINOTELEPHONE:
(818) 282-1223
CITY:SAN GABRIELSTATE: CAZIP CODE:
91775
CAPACITY: 40TOTAL ENROLLED CHILDREN: 38CENSUS: 8DATE:
08/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Claudia Arias, Site Director/TeacherTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 08/08/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management visit. A COVID-19 risk assessment was conducted. LPA met with Claudia Arias, Site Director/Teacher and explained the purpose of the visit. LPA observed 8 children with 1 staff member.

The reason for today’s visit is to follow up on an incident that occurred on 07/22/2024 and was reported to the department on 07/31/2024. The self reported incident is regarding supervision.

During today's visit, LPA interviewed Staff #1 (S1) and Child #2 (C2) and Child #3 (C3).

There are no deficiencies being cited today, as the incident requires further investigation.

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: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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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