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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018287
Report Date: 10/14/2022
Date Signed: 10/14/2022 10:46:07 AM


Document Has Been Signed on 10/14/2022 10:46 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:PLAZA DE LA RAZA - MAIZELANDFACILITY NUMBER:
198018287
ADMINISTRATOR:NNEKA ARINZEFACILITY TYPE:
850
ADDRESS:7601 CORD AVE.TELEPHONE:
(562) 205-2789
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:80CENSUS: 50DATE:
10/14/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH: Susana Ramos and Marina Reyna HRTIME COMPLETED:
11:00 AM
NARRATIVE
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At 8:00 am Licensing Program Analyst (LPA) Roxana Lopez and Cynthia Reyes conducted an annual continuation visit to Plaza de la Raza main head quarters located at 13300 Crossroads Pkwy., N. Suite 440 City of Industry, CA. 91746. An annual inspection was conducted on 10/11/2022. The purpose of this inspection is to review staff files as they were not available for review at the Maizeland Head Start facility during the Annual inspection conducted on 10/11/2022. LPA met with Susana Ramos and Marina Reyna, Human Resources who provided LPA with the staff files of the staff present during the inspection from 10/11/2022.

Facility Records: All staff have received an active criminal record clearance as a condition of their employment with Plaza de la Raza.

Staff’s Records were reviewed for completeness: Inspections of required forms was made.

LPA’s issued the Review of Staff Records (LIC 859) to the licensee during this inspection. The LIC 859 documents the staff’s files were reviewed during this inspection.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2022
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: PLAZA DE LA RAZA - MAIZELAND
FACILITY NUMBER: 198018287
VISIT DATE: 10/14/2022
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For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative Susana Ramos and Marina Reyna, Human Resource.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
LIC809 (FAS) - (06/04)
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