197419484-10-25-2022-58-CC-AALA-CKJNYH-20221025105245

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419484
Report Date: 10/25/2022
Date Signed: 10/25/2022 10:52:55 AM

Document Has Been Signed on 10/25/2022 10:52 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LITTLE ACORNS GROW		FACILITY NUMBER:	197419484
ADMINISTRATOR:	MARTIN, MELANIE		FACILITY TYPE:	850
ADDRESS:	19000 SATICOY STREET		TELEPHONE:	(818) 779-1099
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	52	CENSUS: 41	DATE:	10/25/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Director Melanie Martin		TIME COMPLETED:	11:00 AM

NARRATIVE

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On 10/25/2022 at 8:53 AM, Licensing Program Analyst (LPA) Antonio Almanza conducted an unannounced case management visit for the purpose of following up on Action Lead Exceedance (ALE), Facility Inspection. LPA met with Director Melanie Martin and toured the facility. During today’s visit there are 41 children and 6 teachers. 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 08/02/2022. The sample test for the water fountain, located in the breezeway on the left hand side of office, identified on the facility sketch by letter “G”, tested at 8.8 bbp/ug L, which exceeds 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 fountain identified on facility sketch. LPA observed the faucet inaccessible; the faucet is covered with plastic bag and sign,” Do not use Until Removed by Sampler.” The Director is reporting that the water fountain was not in use by children.

Facility has posted testing results, in a location (in front of office/notice board) 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 will 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 “G” via "Procare", parent app.

During today’s visit LPA took pictures of the water fountain(G). LPA received an email from the facility with copies of External Water Sampler Self-Certification Form (LIC 9275); Child Care Center Sampling Checklist Form (LIC 9276); and copy of water testing results. Facility will email LPA an updated copy of Facility Sketch (LIC999) in which all water outlets are noted.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022

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

FACILITY NAME: LITTLE ACORNS GROW	FACILITY NUMBER: 197419484
	VISIT DATE: 10/25/2022

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During today’s visit one Type B violation is being issued per PIN 21-21-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) 21-21CCP 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 the Director Melanie Martin.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/25/2022 10:52 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LITTLE ACORNS GROW	FACILITY NUMBER: 197419484
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/25/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/11/2022 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:
	8 9 10 11 12 13 14	Based on observation, interview and record review, The facility Had water fountain "G" test with Lead Exceedance of 8.8, which poses a potential Health or Safety, or personal rights risk to persons in care.	8 9 10 11 12 13 14	Facility will provide water bottles for children in care until water outlet "G is replaced.
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	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: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022

LIC809 (FAS) - (06/04)

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