191806026-3-23-2023-33-CC-MGAA-CQ7VPD-20230323163633

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191806026
Report Date: 03/23/2023
Date Signed: 03/23/2023 04:36:37 PM

Document Has Been Signed on 03/23/2023 04:36 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:	GREGORY PARK HEAD START/STATE PRE SCHOOL		FACILITY NUMBER:	191806026
ADMINISTRATOR:	MARCIE HOUCHEN		FACILITY TYPE:	850
ADDRESS:	5807 GREGORY AVE.		TELEPHONE:	(323) 463-3061
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90038
CAPACITY:	60	CENSUS: 45	DATE:	03/23/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	10:21 AM
MET WITH:	Samira Alvarez, Head Start Child Development Supervisor		TIME COMPLETED:	11:00 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	Licensing Program Analysts (LPAs) Mireya Garcia and Mary Silva conducted an unannounced case management inspection. Upon arrival LPA met with Head Start Child Development Supervisor, Samira Alvarez. Census was taken. During the inspection LPAs 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 representative 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 LPAs. Facility provided a copy of the facility sketch, LIC 9276, and LIC 9275 to LPA Garcia prior to the inspection. On 12/21/2022, 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 10/13/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows: Report continues on next page 1 of 2.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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 2

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: GREGORY PARK HEAD START/STATE PRE SCHOOL	FACILITY NUMBER: 191806026
	VISIT DATE: 03/23/2023

NARRATIVE

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A drinking fountain located inside the classroom #3 of the facility (9.0 UG/L) – This water fountain was not used since the beginning of 2020 due to the pandemic. After the facility was notified of the result, the fountain was completely removed and replaced on 02/26/2023 per documents provided by the facility. The proof was verified in person during this inspection and pictures were taken.

Since the fountain was removed and replaced after the test results was known to the facility, no deficiencies were cited during this inspection.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with facility representative Samira Alvarez. Appeal rights discussed and explained.

Report ends here page 2 of 2.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2