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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403707
Report Date: 10/26/2022
Date Signed: 10/26/2022 11:26:51 AM


Document Has Been Signed on 10/26/2022 11:26 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:SIERRA MONTESSORI PRESCHOOL, LLCFACILITY NUMBER:
197403707
ADMINISTRATOR:JOANNE VILLA-ROBLESFACILITY TYPE:
850
ADDRESS:18045-47 SIERRA HIGHWAYTELEPHONE:
(661) 252-6422
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY:85CENSUS: 14DATE:
10/26/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Lalanie Herath, LicenseeTIME COMPLETED:
12:00 PM
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On 10/26/22, Licensing Program Analysts (LPAs) Villa and Beneroso conducted a Case Management inspection in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPAs Villa and Beneroso met with the Lalanie Herath (Lisensee), the purpose of the inspection was disclosed, and entry was granted. Upon arrival LPAs observed 14 children and 2 staff present.

During the inspection, LPAs Villa and Beneroso informed licensee the results provided from SWRCB, which indicated the facility had elevated levels of lead in the bathroom drinking fountain, Sample B. The Department was notified of the Action Level Exceedance (ALE) levels at the bathroom drinking fountain, (Sample B) which presented levels of 21.0 UG/L. The SWRCB report sample listed facility inspected and collected sample on 09/23/22. Results were provided to facility on 10/10/22 . Lab ID Number: 469669-002

LPAs observed the water outlet was removed and being in a classroom that is not accessible to children. Per licensee, the classroom where the sink is located has not been used since 03/2020. Sample B was completely removed and will not be replaced. Per licensee, children bring their own water or are provided with water bottles.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SIERRA MONTESSORI PRESCHOOL, LLC
FACILITY NUMBER: 197403707
VISIT DATE: 10/26/2022
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The drinking fountain was not being used for food preparation and or drinking water. Licensee has notified all parents via lette ron 10/21/22 and LPAs observed a sign being posted by the facility's main entrance. Sample B was placed as out of service on 10/10/22 the day the results were obtained. Per Licensee, bathroom drinking fountain (Sample B) will permanently be out of order. Licensee was informed the steps to follow if in the future if she wants to make that water fountain available for use.

Facility is aware the lead levels shall not exceed 5.00 UG/L

An exit interview was conducted, and a copy of this report was provided along with a Notice of Site Visit and appeal rights to licensee, Lalanie Herath.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
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