OPTIONS-SURROUND CARE-JELLICK

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 to follow up on a incident report submitted to the Department on 01/21/2026. Upon arrival at 2pm, LPA met with Facility Representative Brenda Monroy, to whom the purpose of the inspection was explained. A tour of the facility was conducted and census was taken. There were 8 children with 5 staff during the time of the tour. On 01/20/2026, at approximately 4:30pm, while on the outside play area Staff #2 observed two children out of visual observation of Staff #1, who was with a child at the restrooms. During today's inspection, LPA conducted interviews with two staff members. Per Staff #1 (S1), they were by the restroom for a child using it, and was still observing the rest of the children on the play yard. S1 states that a child asked them if they could go retrieve a ball from by the fence, which S1 agreed. Staff #2 (S2) corroborated the placement of S1 and the group of children outside. Both interviews stated that there were about 6 or 7 children present at the time. Per S2, they had exited a classroom and observed S1 at the restrooms. As S2 approached the group, they observed two children around the corner of Jellick 5 classroom, near the gate, trying to get a ball on the other side. Staff #2 instructed the two children to rejoin the group. Both staff corroborated that the two children were not by the fence for that long of time, but could not give me an accurate amount of time. Moving forward, S2 states that S1 brings all children with them near the restrooms when needed, since there was only one staff member present at the time of the incident. Facility was provided an Advisory Note-Technical Violation on 01/21/2026 for an incident similar in nature: lack of supervision. This is the second incident to occur at facility since December 2025. Based on information gathered during today's inspection, LPA is providing a Type B citation for lack of supervision, as two children were out of visual observation for unknown amount of time, but there was no immediate danger to them. LPA is recommending added staff coverage to assist in supervision moving forward. REPORT CONTINUES PAGE 1 of 2 NAME OF LICENSING PROGRAM MANAGER: Ana Chico NAME OF LICENSING PROGRAM ANALYST: Nolan Tcheng LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/12/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2026 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 4 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 e

Type B citation - potential risk if not corrected

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 to follow up on a incident report submitted to the Department on 01/21/2026. Upon arrival at 2pm, LPA met with Facility Representative Brenda Monroy, to whom the purpose of the inspection was explained. A tour of the facility was conducted and census was taken. There were 8 children with 5 staff during the time of the tour. On 01/20/2026, at approximately 4:30pm, while on the outside play area Staff #2 observed two children out of visual observation of Staff #1, who was with a child at the restrooms. During today's inspection, LPA conducted interviews with two staff members. Per Staff #1 (S1), they were by the restroom for a child using it, and was still observing the rest of the children on the play yard. S1 states that a child asked them if they could go retrieve a ball from by the fence, which S1 agreed. Staff #2 (S2) corroborated the placement of S1 and the group of children outside. Both interviews stated that there were about 6 or 7 children present at the time. Per S2, they had exited a classroom and observed S1 at the restrooms. As S2 approached the group, they observed two children around the corner of Jellick 5 classroom, near the gate, trying to get a ball on the other side. Staff #2 instructed the two children to rejoin the group. Both staff corroborated that the two children were not by the fence for that long of time, but could not give me an accurate amount of time. Moving forward, S2 states that S1 brings all children with them near the restrooms when needed, since there was only one staff member present at the time of the incident. Facility was provided an Advisory Note-Technical Violation on 01/21/2026 for an incident similar in nature: lack of supervision. This is the second incident to occur at facility since December 2025. Based on information gathered during today's inspection, LPA is providing a Type B citation for lack of supervision, as two children were out of visual observation for unknown amount of time, but there was no immediate danger to them. LPA is recommending added staff coverage to assist in supervision moving forward. REPORT CONTINUES PAGE 1 of 2 NAME OF LICENSING PROGRAM MANAGER: Ana Chico NAME OF LICENSING PROGRAM ANALYST: Nolan Tcheng LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/12/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2026 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 4 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 e