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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191610282
Report Date: 12/15/2022
Date Signed: 12/15/2022 03:50:12 PM


Document Has Been Signed on 12/15/2022 03:50 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:FERNALD CHILD CARE CENTER - INFANTSFACILITY NUMBER:
191610282
ADMINISTRATOR:ALICIA MINOR BROWNFACILITY TYPE:
830
ADDRESS:10620 SUNSET BLVD.TELEPHONE:
(310) 825-2900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90095
CAPACITY:26CENSUS: DATE:
12/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:Alicia Minor BrownTIME COMPLETED:
04:04 PM
NARRATIVE
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On 12/15/2022 Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced case management visit regarding a lead exceedance level at Fernald Child Care Center-Infant. LPA Thompson was greeted by Alicia Minor Brown (Director) and granted entry into the facility. The director guided LPA Thompson on a tour of the facility. There were 7 teachers 12 toddlers and 8 infants present during the visit.

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 10/20/2022 exceeded allowable limits 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 on the lead testing results of Action Level Exceedances (ALE) and conduct an inspection.

During today’s visit LPA Thompson was unable to observe the water faucet/outlets due to not being able to identify the location on the facility sketch. The facility director stated the facility does not use any water faucet outlets for drinking or preparing food. The facility ceased usage of faucets/outlets for several years and resorted to bottle water service. The director agreed that where faucet/outlet sample P was identified as exceedance of lead shall remain inoperable. LPA was unable to observe outlet location.

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) -301-3061
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
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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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: FERNALD CHILD CARE CENTER - INFANTS
FACILITY NUMBER: 191610282
VISIT DATE: 12/15/2022
NARRATIVE
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The Director stated children and staff does not have access to outlet/fountain sample P. The facility maintenance worker is currently performing the reconditioning process

The facility will provide LPA with a copy of a facility sketch with the labeling of faucet/outlets by 01/05/2023

Per director children bring their own water bottles and water bottles are re-filled with filtered water.



Based on observation, interviews and sampling records it has been determined that there was a violation of Licensing Regulation. The facility was cited a Type B violation 101700.3(b)(1) Please see Facility evaluation Report LIC 809D

This facility is being cited (1) deficiency during today’s visit 12/15/2022. This is a type B violation which poses a potential Health, Safety or Personal Rights risk to children in care.

LPA discussed Proof of Correction (POC) with Director. Director agreed to continue to cease the useage of outlet/faucet letter P which exceeded the allowance level. LPA observed a posting of The final report analysis located on the wall before entering the facility office. LPA observed an emailed letter that was sent to parents/authorized representatives of lead results and plan of correction.

LPA provided facility representative with Instructions for required lead testing outlined in PIN 21-21 CCP and Lead Testing Question and Answers. This PIN contains Written Directives, which have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) -301-3061
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: FERNALD CHILD CARE CENTER - INFANTS
FACILITY NUMBER: 191610282
VISIT DATE: 12/15/2022
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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 issued a technical violation 101703 (a) (2) Post -Testing Requirements and Information

A copy of this facility evaluation report (LIC 809 & LIC 809D), Appeal Rights (LIC9058) and Notice of Site Visit (LIC9213) were reviewed and provided to the Director

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. Failure to maintain posting as required will result in a civil penalty of $100.

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) -301-3061
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 12/15/2022 03:50 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: FERNALD CHILD CARE CENTER - INFANTS
FACILITY NUMBER: 191610282

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/15/2022
Section Cited

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101700.3 California Lead Action Level at Child Care CentersTesting r (b)results with fractional ppb readings of 5.0 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. This requirement was met as evidency by
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Lead water testing samples taken on 10/20/2022 revealed that levels of lead were beyond allowable amount deemed by the State of California. Water fountain sample P lead exceedance level tested at 14 ug/L 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: Rita RamosTELEPHONE: (424) -301-3061
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4