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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408220
Report Date: 04/29/2026
Date Signed: 04/29/2026 03:05:08 PM

Document Has Been Signed on 04/29/2026 03:05 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:S.S.U.C.-CESAR CHAVEZ CHILD DEVELOPMENT CENTERFACILITY NUMBER:
073408220
ADMINISTRATOR/
DIRECTOR:		CRUZ, JACQUELINEFACILITY TYPE:
850
ADDRESS:1187 MEADOW LANETELEPHONE:
(925) 798-1011
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY: 146TOTAL ENROLLED CHILDREN: 146CENSUS: 133DATE:
04/29/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:54 AM
MET WITH:Sumira Thapa and Alejandra Thompson TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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Today, 4/29/2026 at 9:54 AM, Licensing Program Analyst (LPA), Paulita De La Cruz, met with center Director, Sumira Thapa and Education Manager, Alejandra Thompson for the purpose of conducting another visit, unrelated to this one.

During the tour of the classrooms, LPA observed a small cockroach crawling out from/and back underneath a small shelving unit in one of the classrooms.

CCR, Title 22, Section 101238(a)(1) Buildings and Grounds was cited during this visit on Facility Evaluation report LIC 809-D.

Exit interview was conducted and report provided to Education Manager, Alejandra Thompson.

The Notice of Site Visit was provided and must be posted for 30 days. Appeal Rights was also provided.
NAME OF LICENSING PROGRAM MANAGER: Mayla Mendoza
NAME OF LICENSING PROGRAM ANALYST: Paulita De La Cruz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2026
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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California Health & Human Services Agency
California Department of Social Services

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 licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/29/2026 03:05 PM - It Cannot Be Edited


Created By: Paulita De La Cruz On 04/29/2026 at 12:28 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: S.S.U.C.-CESAR CHAVEZ CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 073408220

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/29/2026
Section Cited
CCR
101238(a)(1)

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101238 Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
(1) The licensee shall take measures to keep the center free of flies, other insects, and rodents.
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The center shall ensure all areas are free from flies, other insects and rodents, at all times.
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This regulation has not been met as evidenced by: A small cockroach was observed crawling out from/and back underneath a small shelving unit in one of the classrooms.
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The center is currently on a monthly pest control program and proof was reviewed by LPA during this visit. Center is due for the pest control service for May. Service occurs within the first 2 weeks of the month.

This deficiency is cleared today, 4/29/26.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mayla Mendoza
NAME OF LICENSING PROGRAM MANAGER:
Paulita De La Cruz
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2026


LIC809 (FAS) - (06/04)
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