191870530-2-27-2023-58-CC-AALA-CPFUEL-20230227143119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870530
Report Date: 02/27/2023
Date Signed: 02/27/2023 02:31:25 PM

Document Has Been Signed on 02/27/2023 02:31 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:	YWCA OF LA / DAY CARE CENTER PRESCHOOL		FACILITY NUMBER:	191870530
ADMINISTRATOR:	PRINCESS FOSTER		FACILITY TYPE:	850
ADDRESS:	2519 W. VERNON AVE		TELEPHONE:	(323) 295-4280
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90008
CAPACITY:	73	CENSUS: 30	DATE:	02/27/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Princess Foster, Director		TIME COMPLETED:	10:30 AM

NARRATIVE

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On 02/27/2023 at 8:30 AM, Antonio Almanza, Licensing Program Analyst (LPA) conducted an unannounced case management visit for the purpose of following up on Action Lead Exceedance (ALE), Facility Inspection. LPA met with Princess Foster, Director and toured the facility. During today’s visit there are 30 children and 6 Staff. Risk Assessment was conducted prior to conducting site visit.

Community Care Licensing was notified of the results of the Lead Water Testing conducted at the facility on 01/07/2023. The sample test for the Water Fountain located outside Tiggers Classroom, identified on the facility sketch by letter “F”, tested at 11 bbp/ug L. Water Fountains/Sink Faucets located in the Tiggers Classroom, identified on the facility sketch by letter “C”, “D”, and “E” tested at 6.3, 9.2, and 8.5 bbp/ug L respectively, exceed allowable limit for lead. Test Samples testing over 5.5 ppb/ug L and above is considered an exceedance.

During today’s visit LPA observed water outlets “C”, “D”, “E”, and “F” covered with a plastic bag and “Do not use until removed by sampler” sign. Licensee has posted Lead testing results, in a location (facility lobby/dropp off location) consistent with the requirements of subsection (b) of section 1596.8595 of the Health & Safety Code, for parents and families to view at the facility within 24 hours of receiving the results from the Department. Facility notify all parents or guardians of children in care of Lead Exceedance results and what has been done to date and remediation plan for water outlet“C”, “D”, “E”, and “F”.

Facility is providing bottled water for the children to drink. Facility has 5 gallon, Readyfresh water dispenser and is pending the delivery of 5-gallon water bottles. Facility has portable sink for children to wash their hands inside and outside while sinks are being repaired. Licensee is going to have the water fixtures and water lines replaced.

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YWCA OF LA / DAY CARE CENTER PRESCHOOL	FACILITY NUMBER: 191870530
	VISIT DATE: 02/27/2023

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During today’s visit LPA took pictures of the water outlets “C”, “D”, “E”, and “F”. LPA received copies of External Water Sampler Self-Certification Form (LIC 9275); Child Care Center Sampling Checklist Form (LIC 9276); Facility Sketch (LIC 999) in which all water outlets are noted; and a copy of water testing results summary.

One Type B violation is being issued per PIN 21-21.1-CCP, Title 22 Regulations, Division 12, and Subchapter 5: 101700.3(b)(1) California Lead Action Level at Child Care Centers: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

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.

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. LPA emailed and provided the Director with the Provider Information Notice (PIN) 21-21.1-CCP and Lead Testing in Child Care Centers Frequently Asked Questions.

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 $100.00.

A copy of this Report (LIC809 & LIC809D), Appeal Rights (LIC9058) and Notice of Site Visit (LIC9213) were reviewed and provided to Director Princess Foster.

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/27/2023 02:31 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: YWCA OF LA / DAY CARE CENTER PRESCHOOL	FACILITY NUMBER: 191870530
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/27/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/27/2023 Section Cited	1 2 3 4 5 6 7	101700.3(b)(1), California Lead Action Level at Child Care Centers: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This Requirement is not met as evidenced by:	1 2 3 4 5 6 7	The facility has made water outlets “C”, “D”, “E”, and “F” inaccessible and agrees to have the fixtures and water lines replaced and retested by 03/27/23.
	8 9 10 11 12 13 14	Based on observation, interview and record review, The Facility water outlets “C”, “D”, “E”, and “F” tested over 5.5 ppb/ug L which is considered an exceedance, which poses a potential Health or Safety, or personal rights risk to persons 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: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

LIC809 (FAS) - (06/04)

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