OPTIONS HEAD START/CDC - MEMORIAL PARK

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced Case Management inspection for the purpose of following up on an incident reported to the Department on 04/14/2025. Upon arrival at 2:50pm, LPA met with Lead Teacher Dioselyn Cortez, to whom the purpose of the inspection was explained. Site Supervisor Michelle Mora was also present. A tour of the facility was provided. There were children present. Census was taken. There were 22 children with 11 staff members. On 04/11/2025, a child was walking to throw away trash and tripped on the play yard, resulting in an injury that required further medical attention. Today's inspection is to determine if the physical grounds was a condition safe for the children being served. Incident report was submitted within the required time period. During today's inspection, two staff interviews were conducted and ouch/incident report was reviewed. During the interviews, Staff disclosed that this has not been the first time a child has tripped on the edge of the cushioned material floor and concrete. LPA reviewed the play ground and observed the small ledge that they state Child #1 tripped on. Pictures were obtained of the play yard areas. Other parts of the cushioned material were observed to be warped and had bumps that staff stated have had others trip as well. Based on the information above, LPA has determined that the there is a violation of Outdoor Activity Space. Floor has not been maintained in a safe condition for the activities planned for children. The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor Michelle Mora, at 4:05pm. Plan of Corrections developed and copy of Report provided. END OF REPORT NAME OF LICENSING PROGRAM MANAGER: Ana Chico NAME OF LICENSING PROGRAM ANALYST: Nolan Tcheng LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2025 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the lice

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced Case Management inspection for the purpose of following up on an incident reported to the Department on 04/14/2025. Upon arrival at 2:50pm, LPA met with Lead Teacher Dioselyn Cortez, to whom the purpose of the inspection was explained. Site Supervisor Michelle Mora was also present. A tour of the facility was provided. There were children present. Census was taken. There were 22 children with 11 staff members. On 04/11/2025, a child was walking to throw away trash and tripped on the play yard, resulting in an injury that required further medical attention. Today's inspection is to determine if the physical grounds was a condition safe for the children being served. Incident report was submitted within the required time period. During today's inspection, two staff interviews were conducted and ouch/incident report was reviewed. During the interviews, Staff disclosed that this has not been the first time a child has tripped on the edge of the cushioned material floor and concrete. LPA reviewed the play ground and observed the small ledge that they state Child #1 tripped on. Pictures were obtained of the play yard areas. Other parts of the cushioned material were observed to be warped and had bumps that staff stated have had others trip as well. Based on the information above, LPA has determined that the there is a violation of Outdoor Activity Space. Floor has not been maintained in a safe condition for the activities planned for children. The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor Michelle Mora, at 4:05pm. Plan of Corrections developed and copy of Report provided. END OF REPORT NAME OF LICENSING PROGRAM MANAGER: Ana Chico NAME OF LICENSING PROGRAM ANALYST: Nolan Tcheng LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2025 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the lice

Type B citation - potential risk if not corrected