191201747-10-5-2023-58-CC-JKAN-CWBRMD-20231005130835

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191201747
Report Date: 10/05/2023
Date Signed: 10/05/2023 01:08:41 PM

Document Has Been Signed on 10/05/2023 01:08 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	EGREMONT SCHOOLS, INC		FACILITY NUMBER:	191201747
ADMINISTRATOR:	CLAUDIA NEWBY		FACILITY TYPE:	850
ADDRESS:	19850 DEVONSHIRE		TELEPHONE:	(818) 363-7803
CITY:	CHATSWORTH	STATE: CA	ZIP CODE:	91311
CAPACITY:	42	CENSUS:	DATE:	10/05/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Director / Tina Struve		TIME COMPLETED:	01:30 PM

NARRATIVE

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Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an unannounced case management inspection on 10/5/2023. LPA arrived at the facility at 10AM and met with Director / Tina Struve, who guided analyst on a tour of the facility. LPA observed 16 children with 4 staff upon arrival in the pre-school program.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test.

On 10/2/2023, LPA contacted the facility and spoke to the Director / Tina Struve informing them that the required lead testing conducted at the facility has been identified to have an Action Lead Exceedance (ALE) greater than 5.5 ppb in 3 of their water outlets. The purpose of the inspection is to ensure that the water outlets with a lead exceedance are not in use and that the facility has potable water for children in care.

During the inspection LPA observed Arrowhead pure water in every classroom as a potable source of water for children in care. Per the Director, the children do not use any of the drinking fountains. Arrowhead water bottles are also available for children.

LPA was provided with copies of the LIC 9275 External Water Sample Self-Certification Form, the LIC 9276 Child Care Center Sampling Checklist Form, and an updated copy of the LIC 999 Facility Sketch noting all water sources at the facility. LPA was also provided with a copy of the results of the lead water sample testing conducted by Fun Guy Inspection & Consulting, Inc. Testing was conducted on 8/31/2023 and results were received on 9/5/2023. Per the water sample results, the facility had three water outlets with a lead exceedance.

The following water outlets yielded the following results:

1. Sample 191201747-B – Kitchen – South Sink (cold) – 77.9ppb

2. Sample 191201747-A – Kitchen – North Sink (cold) – 8.91ppb

(please see LIC 809C / Pg. 2 for additional information)

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Joe Katrdzhyan	TELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: EGREMONT SCHOOLS, INC	FACILITY NUMBER: 191201747
	VISIT DATE: 10/05/2023

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Pg. 2

3. Sample 191201747-C – Kitchen – West Sink (cold) – 31.6ppb

4. Sample 191201747-C30 – Kitchen West Sink (cold) – 8.98ppb (according to Robert Santanastasio from Fun Guy Inspection & Consulting, this is part of Sample 3 and is the 30 second draw. LPA requested Mr. Santanastasio to submit in writing clarifying the information provided and once the Director receives the information in writing, a copy will be forwarded to LPA Katrdzhyan, via email)

LPA took pictures during the inspection. The water outlets in Samples A, B and C were not covered/taped/sealed off. There was no label stating “DO NOT USE.”

Per Director / Tina Struve, The kitchen sinks with lead exceedance are not being used. The school uses an outside catering company (Tiko’s Catering) that delivers lunch daily. The lunch is prepared off site and delivered in self-contained containers.

Due to the facility having an ALE of 5.5 ppb, which poses a potential health, safety, and personal rights risk to children in care, the following deficiency is being cited in accordance with California Code of Regulations Title 22.

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

Exit interview conducted and report was reviewed with Director / Tina Struve.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Joe Katrdzhyan	TELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/05/2023 01:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: EGREMONT SCHOOLS, INC	FACILITY NUMBER: 191201747
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/05/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/12/2023 Section Cited CCR 101700.3(b)(1)	1 2 3 4 5 6 7	101700.3(b)(1) (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.	1 2 3 4 5 6 7	Licensee will ensure that the three water sources, outlet A, B, and C with an action level exceedance are covered/taped/sealed off and there is a label stating “DO NOT USE.” Proof of correction (POC) must be submitted to CCL by the POC due date.
	8 9 10 11 12 13 14	This requirement was not met as evidence by: Based on record review, the licensee did not ensure water sources at facility meet lead requirements. Lead test results showed that three water sources, outlet A, B, C, have an action level exceedance. This poses a potential Health, Safety or Personal Rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Joe Katrdzhyan	TELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

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