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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870969
Report Date: 12/07/2022
Date Signed: 12/07/2022 11:48:36 AM


Document Has Been Signed on 12/07/2022 11:48 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 CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:TWENTY EIGHTH STREET EARLY EDUCATION CENTERFACILITY NUMBER:
191870969
ADMINISTRATOR:WENDY PEELFACILITY TYPE:
850
ADDRESS:747 E 28'TH STREETTELEPHONE:
(323) 231-6921
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:162CENSUS: 49DATE:
12/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Wendy Peel, PrincipalTIME COMPLETED:
12:00 PM
NARRATIVE
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On December 7, 2022, at 10:45 a.m., Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced case management inspection and met with Principal Wendy Peel. LPA disclosed the purpose of the inspection and was granted entry into the facility by Principal.

There were 49 children and 18 staff present during the inspection.

The purpose of today's inspection was to discuss the water lead test results. Results show that three water sources have action level exceedance (ALE) of lead. The drinking fountains located inside of Room#1 and Room #2 and the drinking fountains and fill station outside Room#1 had a lead exceedance of 23 points per billion (ppb), 30ppb, and 6ppb.

At 11:00 a.m. LPA observed and tested the water sources with ALE. Water sources were operable. Principal informed LPA that the ALE had already been corrected. Filters were added to all affected water sources. Principal provided LPA with retest results showing levels of 3.9 ppb and under 1ppb for identified sources. LPA observed both initial and retest lead results posted in the main office. A deficiency was cited to ensure that the water faucets with the exceedance will not be used as a drinking source or food preparation source for the children. Letter of correction was provided during today's visit.

The deficiency listed on the following page was observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and Plans of Correction was reviewed and developed with Principal. A copy of this report and appeal rights were discussed and left with Principal, Wendy Peel, whose signature on this form confirm receipt of these documents. -----------------PAGE 1
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022
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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Document Has Been Signed on 12/07/2022 11:48 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 CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: TWENTY EIGHTH STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191870969

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2022
Section Cited

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101700.3(b)(1)
(b) Testing results with fractional ppb readings of 0.5 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 not met as evidence by:
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Based on record review the licensee did not ensure water sources at facility meet lead requirements. Lead test results showed that three water sources have an action level exceedance. LPA observed water sources are inaccessible to children.
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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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022
LIC809 (FAS) - (06/04)
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