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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191606802
Report Date: 06/16/2023
Date Signed: 06/19/2023 02:09:31 PM


Document Has Been Signed on 06/19/2023 02:09 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:CHILD LANEFACILITY NUMBER:
191606802
ADMINISTRATOR:ROBERTA RAMIREZFACILITY TYPE:
850
ADDRESS:769 W. 3RD STREETTELEPHONE:
(310) 514-4999
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:62CENSUS: 52DATE:
06/16/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Site Supervisor Alma Salinas TIME COMPLETED:
04:30 PM
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on 6/16/2023 Licensing Program Analyst (LPA) Dalicia Adkins conducted an unannounced case management visit/ lead testing exceedance visit. LPA Adkins was greeted by site supervisor Alma Salinas, LPA Adkins was guided on tour of the facility. LPA observed ten teachers supervising fifty two children.

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
1/31/23 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 Adkins observed faucets/outlets identified as exceedance located in the kitchen. LPA Adkins confirmed with site supervisor that outlet/faucet A samples were 8.9 and identified as exceedance. LPA observed outlets of exceedance made inaccessible; taped with plastic and out of service signage. Per site supervisor outlets were used for washing dishes and food consumption. When made aware of exceedance facility immediately ceased use of faucet and made inaccessible. Parents notified via GoAdviro.com app. As stated in the written directives facility conducted a series of water flushing.
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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2023
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CHILD LANE
FACILITY NUMBER: 191606802
VISIT DATE: 06/16/2023
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 As an alternative facility will be using bottle water. Children also bring bottled water and facility will also provide bottle water for children. Each class has an igloo cooler and has available water at all times.

Based water sampling records it has been determined that there was a violation of Licensing Regulation 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 1/31/2023 were 8.9 UG/L which exceeds the allowable amount of of 5.5 ppb (ug/L). 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 site supervisor. Site Supervisor agreed to cease the use of outlet/faucet A and will exclusively provide bottle water for persons in care.
Per director results of second testing is pending. Site Supervisor will send LPA results via email. Certified External Water Sample LIC 9275, Child Care Center Sampling Checklist form completed (LIC 9276), facility sketch completed and will be sent to LPA Adkins via email on 6/20/2023.

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. 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 LPA Adkins provided technical assistance and discussed wavier for drinking water as outlined in PIN 21-21-CCP.

Exit interview conducted and appeal right explained. This report reviewed with licensee and copy provided.
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 06/19/2023 02:09 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: CHILD LANE
FACILITY NUMBER: 191606802

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/16/2023
Section Cited

101700.3(b)(1)

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101700.3(b)(1) California Lead Action Level at Child Care Centers(b)Testing results with fractional ppb reading...(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidence by:
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Ceased use of outlet/faucet A, made inaccessible by wrapping with plastic and placing do not use signage. Parents were notified, and licensing forms completed.
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Based on lead sampling results, outlet A tested at 8.9 ppb which is beyond allowable amount deemed by the State of California, this poses a potential Health and Safety or Personal Rights 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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2023
LIC809 (FAS) - (06/04)
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