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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334812665
Report Date: 12/07/2021
Date Signed: 12/07/2021 01:34:12 PM

Document Has Been Signed on 12/07/2021 01:34 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ESCUELA DE LA RAZA UNIDA, INC. CHILD DEV. CTR.FACILITY NUMBER:
334812665
ADMINISTRATOR:ANGELA GREENFACILITY TYPE:
830
ADDRESS:316 NORTH CARLTON AVENUETELEPHONE:
(760) 922-9080
CITY:BLYTHESTATE: CAZIP CODE:
92225
CAPACITY: 21TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
12/07/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:04 AM
MET WITH:Angela GreenTIME COMPLETED:
02:00 PM
NARRATIVE
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On 12/7/2021, Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to conduct an inspection regarding an unrelated issue to the deficiency observed today. LPA Lopez toured the facility and observed Preschool children in the infant room. Also observed was an infant child commingled amongst them. LPA Lopez brought the issue to the Director Angela Green and she walked the Preschool children to their assigned classrooms.

The observation made, as described above, constitutes a violation regulations.

See LIC 809-D for deficiency cited.

Exit interview conducted and report was reviewed with the Director Angela Green.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2021
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 12/07/2021 01:34 PM - It Cannot Be Edited


Created By: Samuel Lopez On 12/07/2021 at 12:55 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: 334812665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/14/2021
Section Cited
CCR
101438.3(b)

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Indoor Activity Space for Infants: Indoor activity space for infants shall be physically separate from space used by children in the child care center and school-age child care center components. During today's inspection,
Preschool children were observed inside of the infant room, with an infant child amongst them.
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The Preschool children were immediately re-directed away from the infant room and to their assigned classroom. Facility Representative agrees to submit a plan for future compliance with the cited regulation. Written plan to be submitted to the Riverside Child Care Regional Office by 12/14/2021.
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This poses an immediate risk to the Health, Safety, and Personal Rights of the children in care.
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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:Aaron Ross
LICENSING EVALUATOR NAME:Samuel Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2021


LIC809 (FAS) - (06/04)
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