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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016244
Report Date: 10/21/2021
Date Signed: 10/21/2021 10:51:05 AM

Document Has Been Signed on 10/21/2021 10:51 AM - It Cannot Be Edited

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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PLAZA CS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198016244
ADMINISTRATOR:MARIA PEREZFACILITY TYPE:
850
ADDRESS:4198 UNION PACIFIC AVENUETELEPHONE:
(323) 369-7681
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 98TOTAL ENROLLED CHILDREN: 32CENSUS: 26DATE:
10/21/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Site Supervisor-Maria Villegas and Director-Rosalba BravoTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced case management inspection due to an incident that occurred on 10/08/21. LPA met with Site Supervisor -Maria Villegas who guided LPA on a tour of the facility. There were 26 children and 6 staff present upon arrival. LPA observed staff and children wearing masks. Site Director Rosalba Bravo arrived a few minutes later.

The purpose of the inspection was to follow-up on the incident that was reported to the Department. The incident that occurred on 10/08/21 was reported to the Department on 10/12/21. Per the Reporting Party, they were not made aware of the incident until 10/11/21 at 5PM (after close of business). The incident was then reported to the Department on 10/12/21.

Information reported to the Department indicated that Staff #1 violated Child #1’s personal rights.
Based upon information received from the Unusual incident report, interviews conducted, and records reviewed, it was confirmed that Staff #1 was terminated from the Plaza Child Services Program on 8/13/21. Per Director, facility staff will undergo training regarding appropriate discipline, the facility policies and personal rights.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Exit interview was conducted with Site Supervisor, Maria Villegas- The content of this report along with Appeal Rights were read and discussed with the noted person.
Valarie Cook
Jeanette Estrada
DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2021
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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