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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191503832
Report Date: 05/31/2023
Date Signed: 05/31/2023 12:49:55 PM


Document Has Been Signed on 05/31/2023 12:49 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MONTEREY PARK CHRISTIAN SCHOOLFACILITY NUMBER:
191503832
ADMINISTRATOR:VERONICA TOLOSAFACILITY TYPE:
850
ADDRESS:1951 SOUTH GARFIELD AVETELEPHONE:
(323) 890-4545
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91754
CAPACITY:96CENSUS: 25DATE:
05/31/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Director Sandra Wong TIME COMPLETED:
01:00 PM
NARRATIVE
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On 05/31/2023, at 12:00 PM, Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. A COVID 19 risk assessment was conducted prior to entering the facility. LPA met with facility Director Sandra Wong during the visit. Census was taken-. facility was within ratio & capacity.

Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

Facility provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to the department. On 9/8/2022, the Department received notification from the State Water Resources Control Board(SWRCB), Division of Drinking Water (DDW).

The SWRCB report indicated the facility was inspected and samples were collected on 08/22/2022. Faucets reported with 5.5 ppb or greater lead exceedance levels were as follows:
----------------------------- pg. 1 of 2 --------------------------------------------------------------
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTEREY PARK CHRISTIAN SCHOOL
FACILITY NUMBER: 191503832
VISIT DATE: 05/31/2023
NARRATIVE
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• Kitchen Faucet (5.9 UG/L) – During inspection LPA took picture of new faucet installed
Director stated that the kitchen faucet was removed, replaced and retested. New result indicate that Kitchen faucet has passed the lead testing on 12/8/2022. Results were emailed to the department on 1/12/2023.

See LIC809D for Type B deficiency cited. Since faucet has been replaced this citation was cleared on this date. Proof of correction letter was provided to the director.

A notice of site visit was also provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative, Director Sandra Wong ------------------------ pg. 2 of 2 -------------------------------------------------------
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/31/2023 12:49 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MONTEREY PARK CHRISTIAN SCHOOL
FACILITY NUMBER: 191503832

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2023
Section Cited
CCR
101700.3(b)(1)

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101700.3(b)(1)California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater.., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not me at evidenced by
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During the inspection LPA observed that Kitchen faucet had been replaced and retested. Lead testing passed on 12/08/2022. Proof of correction letter was provided.
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Based on ispection, the licensee did not comply with the directive above, as the kitchen faucet tested with an Action Level Exceedance (ALE) of 5.9. This poses a potential health and safety risk to 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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3