198019192-5-10-2022-54-CC-JESA-CEAU6P-20220510151839

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019192
Report Date: 05/10/2022
Date Signed: 05/10/2022 03:18:48 PM

Document Has Been Signed on 05/10/2022 03:18 PM - 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 CHILD DEVELOPMENT CENTER- INFANT		FACILITY NUMBER:	198019192
ADMINISTRATOR:	CIRENIA BARRERA		FACILITY TYPE:	830
ADDRESS:	648 SOUTH INDIANA ST		TELEPHONE:	(323) 268-9615
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY:	6	CENSUS: 5	DATE:	05/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Site Supervisor Denisse Calderon		TIME COMPLETED:	02:59 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/10/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA met with Site Supervisor Denisse Calderon who guided analyst on a tour of the facility. This is an infant program which consists of 1 classroom. Facility operates from Monday through Friday 6AM to 6PM. Present during today's inspection were 5 children with 3 staff. Ages in care are 0 to 18 months. Teacher-Child ratio was observed to be in accordance with Title 22 Regulations. All areas identified on this report were inspected. All children were observed to be under visual supervision of a teacher at all times. Classroom was observed to ensure that infants are never left unattended and under the direct visual supervision of a staff person at all times. The following was observed during the tour of the facility: Children's roster was reviewed and is current. Sign-in and out procedures were reviewed. Children present were signed in. LPA observed required licensing documents posted on bulletin board in the main entrance to the facility and in the infant classroom. Indoor space is physically separate from other child care components. Furniture and equipment were inspected for age appropriateness and good repair. Toys were observed to be safe, and do not have sharp points, edges, splinters and are not made of small parts that can pose a choking hazard. LPA did not observe any baby walkers or any items that fall into that category present in the facility. The classroom was inspected to ensure that the floors have a surface that is safe and clean. LPA observed carpets and soft play mats on the floor of the classroom. LPA observed children have their own cubby to store their belongings in each classroom. Napping equipment was observed to be physically separate from the indoor activity space . This area is surrounded by a see-through panel. Storage for infants’ belongings and napping equipment/cribs was inspected and meet all regulatory requirements. LPA observed cots for napping used by older infants and one crib used by one infant. Per Site Supervisor, 1 teacher is always supervising the nap room while infants sleep. (LPA discussed Safe Sleep Practices).Linens cleaned everyday by staff. Age appropriate sinks and toilets were inspected for availability and good repair in the restroom. There is a restroom with 2 sinks and 2 toilets inside the classroom next to the diaper changing area. There is a diaper changing table in the infant classroom with a sink within arms reach. General sanitation was observed. The infant changing table has raised sides that are at least 3 inches high.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

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

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PLAZA CHILD DEVELOPMENT CENTER- INFANT	FACILITY NUMBER: 198019192
	VISIT DATE: 05/10/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 2
Telephone service, heating, lighting and ventilation were evaluated and are in operating condition. Per site supervisor, the isolation area is located in classroom away from other children Drinking water is provided via a water dispenser. First Aid supplies were observed in the classroom near the exit door.
Disinfectants, cleaning solutions, and other items that are dangerous to children, were observed to be inaccessible. Site Supervisor states at this time they have no children requiring medication. Medication would be stored in a locked cabinet in the classroom. Site Supervisor states that there are no poisons stored at the facility and understands that storage areas for poisons must be locked with a key or combination lock. Facility has one or more functioning carbon monoxide and smoke detectors that meet statutory requirements.
LPA observed kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. Meals are prepared in the kitchen and are distributed to the classroom ready to serve. Menus were reviewed to ensure that they are being posted at least one week in advance. The facility provides breakfast, lunch and snack for children who eat table food (per needs and service plan). Children who do not consume table food bring their own formula and it is kept in the classroom. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. All foods/beverages are stored in covered containers at 45˚ (F) or less.
Outdoor space is physically separate from the other child care components. Outdoor play equipment was observed to be in good condition, free of sharp, loose, or pointed parts. LPA observed outdoor activity space surface to have soft cushioning material that is maintained in a safe condition and is free of hazards. Areas around and/or under climbing equipment and slides have cushioning material to absorb a fall. The outdoor area has adequate shade. A water dispenser is available if needed. Site Supervisor states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. Site Supervisor states there are no weapons or firearms on the premises and none observed.
There is at least one person trained in CPR and Pediatric First Aid present during this inspection.
Children’s Records were reviewed for completeness included infant needs and services plan; Inspection of required forms was made and documented on the LIC 857. LPA also reviewed staff records. The review of Staff records was documented on the LIC 859.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PLAZA CHILD DEVELOPMENT CENTER- INFANT	FACILITY NUMBER: 198019192
	VISIT DATE: 05/10/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 3
Staff present did have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present did have proof against TB, measles, pertussis, and/or a declination for influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions.
Disaster drill log was available. Fire drill was conducted on 1/20/22 and Earthquake drill was conducted on 1/13/22.
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.
Medication: This facility provides Incidental Medical Services – IMS. LPA discussed storage of medication and equipment/supplies with Site Supervisor, and reviewed children’s, personnel, and administrative records. Per site supervisor there are no children who currently require medication. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. 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. 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/tion-process. A current email address was collected during today's visit.
The deficiency listed on the following page were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. Deficiencies that are being cited 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. Appeal Rights were provided.
Exit interview conducted and report was reviewed with the Facility Representative, Denisse Calderon .

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 05/10/2022 03:18 PM - It Cannot Be Edited

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PLAZA CHILD DEVELOPMENT CENTER- INFANT	FACILITY NUMBER: 198019192
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/10/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101170(e)(2)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in two out of four staff present which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/11/2022
	Plan of Correction
1 2 3 4	Site Supervisor will submit LIC 9182 Criminal Record Transfer Request to RO by due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC809 (FAS) - (06/04)

Page: 4 of 4