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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412693
Report Date: 09/15/2022
Date Signed: 09/15/2022 02:04:49 PM


Document Has Been Signed on 09/15/2022 02:04 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:KADIMA HEBREW ACADEMY-ECEC,DBA KADIMA DAY SCHOOLFACILITY NUMBER:
197412693
ADMINISTRATOR:ALISHA SELAFACILITY TYPE:
850
ADDRESS:7011 SHOUP AVENUETELEPHONE:
(818) 346-0849
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:105CENSUS: 78DATE:
09/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Leslie Maltz, Lead TIME COMPLETED:
02:12 PM
NARRATIVE
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On 9/15/22 9:15am Licensing Program Analyst (LPA) Denise Miranda arrived at Kadima Hebrew Academy – ECE – DBA Kadima Day School to conduct an unannounced case management visit.

Upon arrival, LPA observed the facility have two firearm securities, per Lead Teacher Ms. Leslie Maltz (Steier), school don’t have a firearms waiver on file.

LPA Miranda was greeted by Lead teacher Ms. Leslie Maltz (Steier) and Mr. Jose Avina, Director of plant operations and Dr. Steven Lorch, Head of the School, LPA informed about the purpose of the visit and guided on a tour of the facility. During this inspection Director was not present. There are 17 staff were present with 78 children.

At 10:29am Facility conducted a fire drill and all children, staff and LPA evacuated the building. At 10:42am, Facility concluded the fire drill and all children, staff and LPA were dismissed to return to the facility.

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.

Community Care Licensing was notified that lead water testing conducted at the facility on 6/27/2022 failed allowable limit. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE).

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
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 5


Document Has Been Signed on 09/15/2022 02:04 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: KADIMA HEBREW ACADEMY-ECEC,DBA KADIMA DAY SCHOOL
FACILITY NUMBER: 197412693

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/16/2022
Section Cited

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101238 (g) (2) Buildings and Grounds: (m) Firearms and other weapons shall not be allowed on or stored on the premises of a child care center. The requirement is not met as eveidenced.
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On 9/15/2022 Upon arrival, LPA observed two securities guard with firearms. Per Director of Plant and Lead Teacher, the facility did not report to DSS and do not have a firearms waiver on file. This poses an immediately health & safety risk to the children in care.
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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: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/15/2022 02:04 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: KADIMA HEBREW ACADEMY-ECEC,DBA KADIMA DAY SCHOOL
FACILITY NUMBER: 197412693

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2022
Section Cited

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101238. a. Building and Grounds (a) The Child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement not met as evidence by:
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Based on lab report analysis water from the D – Drinking Fountain – Hallway ( 7.5 results Ug/L), and B – Sink_Faucet_Kitchen (5.8 result per Ug/L. These faucets samples taken on 6/27/2022 indicate levels of lead in exceedance. This poses a potential health & safety risk to the children in care.
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LPA provided the following documents: PIN 21-21 CCP Release of the written Directives for Lead Testing of Water in Licensed, Child Care Centers per AB2370, flyer PUB 515 Effects Of Lead Exposure, this form facility must be given to the parents of each child in care and flyer of Lead Testing in Child Care Centers - Fact Sheet AB2370 – Water Testing Requirements and How to apply for Free Services.

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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: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
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: KADIMA HEBREW ACADEMY-ECEC,DBA KADIMA DAY SCHOOL
FACILITY NUMBER: 197412693
VISIT DATE: 09/15/2022
NARRATIVE
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regulations contained in Title 22 of the California Code of Regulations.

Child Care Centers are expected to use an Environmental Laboratory Accreditation Program (ELAP), for lead testing. Accreditation from the California Environmental Laboratory Accreditation Program, known as an ELAP laboratory, is equipped to measure the amount of lead in parts per billion (ppb) unit of measurement.

On 09/14/2022, Director submitted a copy of the results of analyses for water sample, sketch that needs to be revised showing the rooms areas and photos were provided to LPA via email. Per photos received from Director of the location of water fountain and the sink located at the kitchen area were placed a yellow tape and will be out of service.

During this inspection, LPA observed the water fountain that is located by classroom#5, room 115 had a yellow tape making this water fountain inaccessible to the children in care. Per Lead Teacher, children bringing their own water and if they need water refill, the facility will provide a refill water from the sink located on kitchen area, that was test and no lead was found it.

LPA observed the sink located at the kitchen area that had exceed lead results without yellow tape. Per Lead Teacher, this sink faucet is using only for wash dishes. Per facility is not using for food preparation or drinking water, LPA recommended to continue leave this area as an off-limit, until facility make the necessary corrections.

LPA obtained a copy of he report LIC9276 Child Care Center Sampling Checklist form and LIC9275 External Water Sampler Self-Certification Form dated on 06/27/2022.

LPA provided the following documents: PIN 21-21 CCP Release of the written Directives for Lead Testing of Water in Licensed, Child Care Centers per AB2370, flyer PUB 515.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: KADIMA HEBREW ACADEMY-ECEC,DBA KADIMA DAY SCHOOL
FACILITY NUMBER: 197412693
VISIT DATE: 09/15/2022
NARRATIVE
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Instructions for required lead testing are outlined in PIN 21-21 - CCP. This PIN which contains Written Directives, have the same force and effects as the

Effects Of Lead Exposure, this form facility must be given to the parents of each child in care, flyer of Lead Testing in Child Care Centers - Fact Sheet AB2370 – Water Testing Requirements and How to apply for Free Services and Lead Testing in Child Care Centers Frenquently Asked Questions.

Also, LPA observed at the kitchen area have tree trash cans and two of containers it was observed with waste food inside. Advisory notes was issued.

The facility was found no be in compliance per Title 22 regulations, Type A and B deficiencies will be cited today 09/15/2022.

The Lead Teacher and Director of the Plant operations were advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224). A copy of LIC9224 was provided to Lead Teacher.



A copy of this report along with a Notice of Site Visit and appeal rights was provided to Lead Teacher Ms. Leslie Maltz (Steier) that has been designated by Director, form LIC308 Designation of responsibility of the facility was obtained during this inspection.

Lead Teacher was made aware that all other Licensing reports must be made available to the public for 3 years.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC809 (FAS) - (06/04)
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