191600678-10-21-2022-30-CC-JLAO-CKENYR-20221021105309

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191600678
Report Date: 10/19/2022
Date Signed: 10/21/2022 10:53:31 AM

Document Has Been Signed on 10/21/2022 10:53 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	TEMPLE ISAIAH PRE-SCHOOL CENTER		FACILITY NUMBER:	191600678
ADMINISTRATOR:	TAMAR ANDREWS		FACILITY TYPE:	850
ADDRESS:	10345 W PICO BLVD		TELEPHONE:	(310) 553-3552
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY:	306	CENSUS: 118	DATE:	10/19/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Tamar Andrews and Avital Edtehad		TIME COMPLETED:	01:30 PM

NARRATIVE

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On 10/19/2022 at 12:30 am Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced case management visit. LPA Laureano was greeted by director Tamar Andrews and Avital Edtehad and granted entry into the facility. Director guided LPA Laureano on a tour of the facility. There were 118 children present during inspection and 22 teachers providing care and supervision.

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.

Community Care Licensing was notified that lead water testing conducted at the facility on 8/30/2022 exceeded allowable limit for lead. Samples testing over 5.5 ppb/ug L and above is considered an exceedance. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE) and conduct an inspection.

During today’s visit LPA Laureano observed water facet/outlets identified on facility sketch with an Action Lead Exceedance (ALE) of 5.5 ppb or over. Director confirmed that faucet/outlets identified in classroom Yellow Submarine Room 103 and Beautiful Butterfly Room 104 have been made inaccessible to the children in care. LPA did not observed room 201 off limits and not in use. LPA spoke with maintenance to confirmed that all filters have been changed and correction have been completed. Director will have water retested to ensure all corrections have been made.

LPA Laureano confirmed with director and maintenance that outlet/faucets samples were identified as exceedance of lead and shall remain inoperable- sinks in room 103 and room 104 and water fountain outside director’s office. LPA Interviewed director and Associate director Avital Etehand to verify children do not have access to the sinks and faucets that has been identified as exceedance of lead. Children currently have bottled water available and children bring their refillable water bottles.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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 10/21/2022 10:53 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: TEMPLE ISAIAH PRE-SCHOOL CENTER	FACILITY NUMBER: 191600678
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/19/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/19/2022 Section Cited	1 2 3 4 5 6 7	101700.3(b)(1), A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance
	8 9 10 11 12 13 14	Based on observation, interviews, and reveiw of lead water testing sampels taken on 08/30/22 revealed that levels of lead were beyong allowable amoutn deemed by the State of California. 3 sinks and 1 water fountain This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	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: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: TEMPLE ISAIAH PRE-SCHOOL CENTER	FACILITY NUMBER: 191600678
	VISIT DATE: 10/19/2022

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Based on observation, interviews and sampling records it has been determined that there was a violation of Licensing Regulation Title Division 12, Chapter 1, Subchapter 5 – California Lead Action Level at Child Care Centers 101700.3(b)(1), “A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance”. Lead water testing samples taken on 8/30/2022 revealed that levels of lead were beyond allowable amount deemed by the State of California. This facility is being cited (1) deficiency during today’s visit 10/19/2022. This is a type B violation which poses a potential Health, Safety or Personal Rights risk to persons in care. In Accordance with California Code of Regulations. Refer to LIC 809-D.

LPA discussed Proof of Correction (POC) with Director and Associate Director. Corrections have been completed on all faucets identified with an Action Lead Exceedance of 5.5 ppb or over. These outlets will not be accessible for use until a retest has occurred. A notification of letter was sent out to parents with notification of cease of water outlets and remediation for planned for water outlets or alternative. Director will send LPA a copy of the letter via email by 10/19/2022. Facility is currently scheduling for a second test of identified outlets. Director will send LPA a copy of the re-test summary once completed.

Instructions for required lead testing are outlined in PIN 21-21. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations Care Child Centers are expected to use an Environmental Laboratory Accreditation Program (ELAP), for lead testing. Accreditation from the California Environmental Laboratory Accreditation Program, known as an ELAP laboratory, is equipped to measure the amount of lead in a parts per billion (ppb) unit of measurement.

For more information, go to the California Childhood. Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb or call them at (510) 620-5600. Please see Provider Information Notice (PIN) 20-01-CCP for more information about lead toxicity prevention

Director received Notice of Site Visit and copy of this report.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

LIC809 (FAS) - (06/04)

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