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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334812664
Report Date: 07/08/2024
Date Signed: 07/08/2024 01:27:03 PM

Document Has Been Signed on 07/08/2024 01:27 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ESCUELA DE LA RAZA UNIDA, INC. CHILD DEV. CTR.FACILITY NUMBER:
334812664
ADMINISTRATOR/
DIRECTOR:		MARIELA AVINAFACILITY TYPE:
850
ADDRESS:316 NORTH CARLTON AVENUETELEPHONE:
(760) 922-9080
CITY:BLYTHESTATE: CAZIP CODE:
92225
CAPACITY: 52TOTAL ENROLLED CHILDREN: 52CENSUS: 28DATE:
07/08/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Lead Teacher Erica GarciaTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
NARRATIVE
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On 07/08/2024, Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for another purpose. LPA was granted entry to the facility by Lead Teacher, Erica Garcia. The following was observed/discussed:

As part of this visit LPA reviewed a total of six staff members records/files. LPA observed five out of the six staff members did not have immunization records for review. The facility was found to be in violation of the following Health and Safety Code: HSC 1596.7995(a)(1)

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
See LIC809D for type B deficiency cited

Additionally, LPA observed two staff files to have either missing or expired Mandated Reporter Certificates. Facility Representative was made aware of this requirement and was provided the names of the staff members that needs to renew or complete this requirement.
See LIC9102 Technical Violation

An exit interview was conducted, A copy of this report and appeal rights were given to Lead Teacher, Erica Garcia during this inspection on 07/08/2024

A NOTICE OF SITE VISIT WAS GIVEN. FACILITY REPRESENTATIVE WAS INSTRUCTED TO POSTED IT IN A PROMINENT LOCATION AT THE FACILITY. FACILITY REPRESENTATIVE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2024
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 07/08/2024 01:27 PM - It Cannot Be Edited


Created By: Justin Giese On 07/08/2024 at 12:58 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ESCUELA DE LA RAZA UNIDA, INC. CHILD DEV. CTR.
FACILITY NUMBER: 334812664

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/08/2024
Section Cited
HSC
1596.7995(a)(1)

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(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles...

This requirement is not met as evidenced by:
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Facility Representative was made aware of the missing records in staff files and was provided a list and names of individuals that need to provide proof of immunization records. Facility will provide missing immunization records to LPA on or before the stated POC date of 08/08/2024
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Based on LPA observations and records reviewed, 5 out of 6 staff present at the facility did not have proof of immunization records on file. This poses a potential health, safety or personal rights risk to persons in care.
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Submission can be made by email:

justin.giese@dss.ca.gov

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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:Gilbert Sena
LICENSING EVALUATOR NAME:Justin Giese
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2024


LIC809 (FAS) - (06/04)
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