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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274408901
Report Date: 02/07/2024
Date Signed: 02/07/2024 12:38:01 PM

Document Has Been Signed on 02/07/2024 12:38 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MEXICAN AMERICAN OPPORTUNITY FOUNDATION SALINASFACILITY NUMBER:
274408901
ADMINISTRATOR:DELIA VIRGINIA BUENOFACILITY TYPE:
850
ADDRESS:1210 JOHN STREETTELEPHONE:
(831) 758-7425
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 25DATE:
02/07/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Rozhgar AzizTIME COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elizabeth Larios conducted an unannounced Case Management - Annual Continuation. The purpose of today’s visit is to conduct staff interview, review children files, and finish tool inspection. LPA met with the Director Rozhgar Aziz and explained the purpose of today's visit.

Exit interview conducted and report was reviewed with the Director Rozhgar. Deficiency issued during today's inspection and appeal rights were given.



A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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Document Has Been Signed on 02/07/2024 12:38 PM - It Cannot Be Edited


Created By: Elizabeth Larios On 02/07/2024 at 11:52 AM
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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MEXICAN AMERICAN OPPORTUNITY FOUNDATION SALINAS
FACILITY NUMBER: 274408901

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation during tour of facility it was observed in preschool classroom 2 lysol wipes in bottom cabient, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2024
Plan of Correction
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Director immediately removed lysol wipes and made inaccesible to children. Corrected during visit.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Joel Segura
LICENSING EVALUATOR NAME:Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2