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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003377
Report Date: 09/04/2024
Date Signed: 09/04/2024 02:19:16 PM

Document Has Been Signed on 09/04/2024 02:19 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-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: 7CENSUS: 6DATE:
09/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Claudia Arias, Site Director/TeacherTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 09/04/2024, 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 6 children with 1 staff member. A short time later, Amber Cervantes Education Supervisor arrived at the facility and assisted with the visit.

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 #3 (S1) and attempted to interview Child #1 (C1). LPA obtained guardian contact information for C1.

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 Education Supervisor. 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: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2024
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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