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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005301
Report Date: 07/17/2024
Date Signed: 07/17/2024 01:21:55 PM

Document Has Been Signed on 07/17/2024 01:21 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-STATE PRESCHOOL-CALIFORNIAFACILITY NUMBER:
198005301
ADMINISTRATOR/
DIRECTOR:		DEBORAH SLOBOJANFACILITY TYPE:
850
ADDRESS:1125 BAINBRIDGETELEPHONE:
(626) 814-0405
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY: 72TOTAL ENROLLED CHILDREN: 24CENSUS: 16DATE:
07/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Linda Dagne, Education SupervisorTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 07/17/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted. LPA met with Linda Dagne, Education Supervisor and explained the purpose of the visit. There are 24 children enrolled. 16 children with 7 staff members are present in 3 classrooms.

The purpose of the visit is to follow up on an incident that occurred on 07/08/2024 and was reported to the department on 07/09/2023. The self reported incident is regarding supervision and physical environment.

During today's inspection, LPA toured the middle classroom, interviewed Staff #1 (S1), Staff #2 (S2) and interview Child #1 (C1) and Child #2 (C2).

Based on interviews with S1, S2, C1, C2 there were no corroborating information to determine that a supervision or physical environment violation occurred. LPA toured the classroom where the incident occurred and did not observed any tripping hazards. 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: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2024
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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