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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870959
Report Date: 05/10/2022
Date Signed: 05/10/2022 03:17:11 PM

Document Has Been Signed on 05/10/2022 03:17 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 CENTERFACILITY NUMBER:
191870959
ADMINISTRATOR:CIRENIA BARRERAFACILITY TYPE:
850
ADDRESS:648 SOUTH INDIANATELEPHONE:
(323) 268-9640
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 110TOTAL ENROLLED CHILDREN: 110CENSUS: 21DATE:
05/10/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Denisse CalderonTIME COMPLETED:
03:30 PM
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On 5/10/22 LPA conducted an unannounced visit to the above facility. LPA met with Site Supervisor Denisse Calderon. There were 21 children present and 4 staff present. LPA notified the Site Supervisor of the reason for the visit. LPA and Site Supervisor reviewed and conducted a COVID 19 follow up.
There were no citations during this visit.

Exit interview conducted with Site Supervisor Denisse Calderon. Notice of Site visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
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)
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