Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500006
Report Date: 02/22/2017
Date Signed 02/22/2017 03:23:33 PM

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 SURROUND CARE-BLANDFORDFACILITY NUMBER:
191500006
ADMINISTRATOR:BERTHA SEQUEIDAFACILITY TYPE:
840
ADDRESS:18605 LINCROFT STREETTELEPHONE:
(626) 913-0603
CITY:ROWLAND HEIGHTSSTATE: CAZIP CODE:
91748
CAPACITY:40CENSUS: 16DATE:
02/22/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Isabel Cervera, Site DirectorTIME COMPLETED:
03:45 PM
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An unannounced Annual Site inspection was conducted by Licensing Program Analyst, Maria Romo, who met with Site Director, Isabel Cervera. LPA conducted a complete tour of the facility.
Program Currently operates AM session from 6:30AM to 9:00 AM and in the afternoon from
12:30 PM to 6:00PM.

Rooms identified on facility sketch were inspected Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and an isolation area with a sink, toilet were inspected. Age appropriate sinks and toilets were inspected for availability and good repair. General sanitation was observed. Children use the Elementary's school bathrooms. Availability of indoor drinking water was observed.

Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness. Required shade, drinking water and fencing were inspected. 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 areas were toured for safety, cleanliness. A review of cleaning and food supply storage areas was made.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Maria RomoTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2017
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 SURROUND CARE-BLANDFORD
FACILITY NUMBER: 191500006
VISIT DATE: 02/22/2017
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The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) (800) 514-0393 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA was informed that IMS is not being provided at the time.
First Aid supplies were inventoried.

Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met.

Main staff and children's files are stored at the Options Surround Care's main office, located at: 304 South 1st St. Alhambra 91801 Tel # (626) 284-9935

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

After a complete inspection of the facility, there were no deficiencies observed on this date according to California Code of Regulations Title 22 Division 12.

An exit interview was conducted and Appeal procedures explained.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Maria RomoTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2017
LIC809 (FAS) - (06/04)
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