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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018287
Report Date: 05/06/2025
Date Signed: 05/06/2025 01:40:56 PM

Document Has Been Signed on 05/06/2025 01:40 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PLAZA DE LA RAZA - MAIZELANDFACILITY NUMBER:
198018287
ADMINISTRATOR/
DIRECTOR:		NNEKA ARINZEFACILITY TYPE:
850
ADDRESS:7601 CORD AVE.TELEPHONE:
(562) 205-2789
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 100TOTAL ENROLLED CHILDREN: 67CENSUS: 56DATE:
05/06/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:05 PM
MET WITH:Cathy Gaeta, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
01:55 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management Incident inspection at the above facility on 05/06/25 at 12:05 p.m. The purpose of this inspection is to follow up on an incident reported to the Department on 04/17/25. LPA met with Site Supervisor Cathy Gaeta who guided LPA on a tour of the facility. Census was taken.

During this inspection, LPA interviewed Staff 1 (S1 thru 2). LPA was not able to interview child 1 (C1). LPA also reviewed C1 file.

On 04/16/25 at approx. 11:15am C1 was walking from the sink to the quiet area and as they approached the area, C1 ran and slipped on a book that was on the rug. C1 fell and hit their head on the bookshelf near the quiet area which resulted in an open wound above their left eye. According to S1, children were transitioning from activities. C1 finished their activity and headed to wash their hands. C1 then headed to the quiet area where there are bookshelf's and other materials for children. S1 recalled hearing someone yell and when they turned around, S1 observed C1 had blood on their face. S1 stated that they immediately attended and comforted C1. S1 also provided first aid and asked for S2s assistance. Per S2, they were notified of the incident and immediately came into the classroom to assist. Per S1, video footage was reviewed with C1s parents, and it is observed that C1 seemed to be skipping happily to the quiet area when suddenly C1 fell. S1 stated that on the video footage it is hard to see if there were books on the floor; however, S1 stated that it is not possible for anything to be on the floor since children had not used the area prior to the incident. According to S1, C1 states that they slipped on a book that was on the floor. S1 also stated that there is always another staff that cleans the classrooms and ensures that all materials are stored away prior to children coming into the classroom.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PLAZA DE LA RAZA - MAIZELAND
FACILITY NUMBER: 198018287
VISIT DATE: 05/06/2025
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Facility contacted C1s parents who took C1 to the doctor. C1 received 3-4 stitches above the left eyebrow and returned to the facility on 04/18/25. Per staff, there are no restrictions; however, C1 must wear a band aid over the stitches while at the facility. Per the written report, the facility conducted a group meeting and discussed with staff that reminders of “walking feet” will be given throughout the routine as needed while indoors. Staff will also remind children to put away materials once they have finished utilizing them. LPA inspected the classroom/area of the incident. LPA did not observe any hazards; however, LPA discussed with S2 that as a best practice all materials shall be put away to prevent slips and falls. Per S2, the bookshelf and other equipment were moved around to prevent future incidents.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative, a civil penalty of $100 can be assessed.

Exit interview conducted and report was reviewed with site supervisor Cathy Gaeta.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2025
LIC809 (FAS) - (06/04)
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