191801098-1-19-2023-33-CC-MJAA-CN8P8P-20230119100553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191801098
Report Date: 01/19/2023
Date Signed: 01/19/2023 10:06:02 AM

Document Has Been Signed on 01/19/2023 10:06 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	BURLINGTON NURSERY SCHOOL AND DAY CARE CENTER		FACILITY NUMBER:	191801098
ADMINISTRATOR:	CECILIA RAMOS		FACILITY TYPE:	850
ADDRESS:	242 NO. BURLINGTON AVE.		TELEPHONE:	(213) 483-0928
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90026
CAPACITY:	90	CENSUS: 23	DATE:	01/19/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Cecilia Ramos, Director		TIME COMPLETED:	10:20 AM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On 01/19/2023, at 8:10 AM, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with facility director, Cecilia Ramos, who guided LPA on a tour of the facility. LPA observed 23 children in care with 9 staff. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility.

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 LPA on 01/18/23.

On 12/16/2022, 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 11/05/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

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: BURLINGTON NURSERY SCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 191801098
	VISIT DATE: 01/19/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

C – Drinking Fountain (8.100 UG/L) – Faucet never used

D- Drinking Fountain (8.100 UG/L) - Faucet never used

F- Drinking Fountain (7.100 UG/L) - Faucet never used

Director stated that the facility never used the drinking fountains as they provide water bottles from Costco and Smart and Final for the facility. The facility has permanently removed the faucets from the facility.

Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit

https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

A Type B deficiency is being cited, please see LIC809D. Facility removed all 3 faucets right away once they were notified of lead exceedence. LPA did not observe any faucets.

An exit interview was conducted and a copy of this report was provided to director Cecilia Ramos, along with Notice of Site Visit. Appeal Rights were also provided and explained to director.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 01/19/2023 10:06 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BURLINGTON NURSERY SCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 191801098
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/19/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/19/2023 Section Cited	1 2 3 4 5 6 7	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 was not met as evidence by	1 2 3 4 5 6 7	Director has permanently removed all three drinking faucets from the facility.
	8 9 10 11 12 13 14	Based on record review, the licensee did not comply with the directive above, as three outlets (outlet used for drinking) out of eleven outlets tested with an Action Level Exceedance (ALE). This poses an immediate 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
	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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3