197419994-11-30-2022-58-CC-SMAZ-CLNW4Y-20221130155820

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419994
Report Date: 11/30/2022
Date Signed: 11/30/2022 03:58:35 PM

Document Has Been Signed on 11/30/2022 03:58 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:	CONCORDIA PRESCHOOL		FACILITY NUMBER:	197419994
ADMINISTRATOR:	GAIL L. SHIPP		FACILITY TYPE:	850
ADDRESS:	16603 SAN FERNANDO MISSION BL		TELEPHONE:	(818) 368-0892
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	60	CENSUS: 34	DATE:	11/30/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Gail Shipp, Director		TIME COMPLETED:	04:00 PM

NARRATIVE

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On 11/30/2022, Licensing Program Analyst (LPA) Sabrina Martinez arrived at Concordia Preschool to conduct an unannounced case management visit. LPA Martinez was met by Director Gail Shipp. LPA Martinez informed Director about the purpose of the visit and was guided on a tour of 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.

The Department was notified that the facility has been identified to have 1 water outlet with an Action Level Exceedance (ALE) in the amount of lead in the water being 5.5 parts per billion (pbb), or greater. The purpose of today’s visit is to ensure that water outlets are not in use and there is a potable source of water for children and staff at the facility.

Director provided LPA with a copy of the results of lead water sample testing conducted by Simple Lab. Testing was conducted on 10/15/2022 and results were received on 10/17/2022. Per the report, the following water outlet yielded the following result:

1.) Water Outlet “E” (Drinking fountain near sandbox): 16 pbb

During today’s visit LPA Martinez conducted a tour of the facility and observed water outlets identified on facility sketch. LPA observed Water Outlet “E bagged, taped, and labeled with the “Out of Service” signage. Director verified that children and staff do not have access to the water outlets that have been identified showing elevated lead levels. Per the Director, the water fixture has been closed and not in use since March 2020 and will be continue to be out of service and inaccessible to all. Director stated that other drinking fountains are available for children to use. Children bring their own snacks and lunches from home. Children also bring two water bottles from home and the facility has a Brita filter in each classroom. Water outlets used for food preparation were not observed to have an Action Lead Exceedance (ALE) of 5.5 ppb or over.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

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: CONCORDIA PRESCHOOL	FACILITY NUMBER: 197419994
	VISIT DATE: 11/30/2022

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During today’s inspection, LPA Martinez obtained the following documents: External Water Sampler Self-Certification Form (LIC 9275), Signed and dated Child Care Center Sampling Checklist Form (LIC 9276), Facility Sketch (fully labeled with locations of all water outlets), and photos of water outlets. LPA will upload the documents to the CA State Water Resources Control Board, Division of Drinking Water Database (DDW) database.

Based on observation, interviews, and supportive documents obtained, it has been determined that the facility has violated Child Care Licensing Regulation Division 12, Chapter 1, 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. Lead water testing samples taken on 10/15/2022 revealed that levels of lead were beyond the allowable amount deemed by the State of California. Water Outlet “E” has Action Lead Exceedance (ALE) level of 16 pbb.

This facility is being cited (1) deficiency during today’s visit 11/30/2022. This is a type B violation which poses a potential Health, Safety or Personal Rights risk to persons in care. Refer to LIC 809-D for deficiency page.

LPA discussed Proof of Correction (POC) with Director. Director stated that the water outlet identified with an Action Lead Exceedance of 5.5 ppb or over have been inoperable since March 2020 and will be continue to be out of service and inaccessible to all. LPA Martinez observed signs posted stating Out of Service. A notification of letter was sent out to parents with notification of cease of water outlets and remediation for planned for water outlets or alternative.

Instructions for required lead testing are outlined in PIN 21-21. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations Care Child 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 a parts per billion (ppb) unit of measurement.

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. Please see Provider Information Notice (PIN) 20-01-CCP for more information about lead toxicity prevention

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted, appeal rights were explained, and report was reviewed with Director Gail Shipp.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 11/30/2022 03:58 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: CONCORDIA PRESCHOOL	FACILITY NUMBER: 197419994
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/30/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/30/2022 Section Cited	1 2 3 4 5 6 7	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: Lead water testing samples taken on 10/15/2022 revealed that levels of lead were beyond the allowable amount deemed by the State of
	8 9 10 11 12 13 14	California. Water Outlet “E” has Action Lead Exceedance (ALE) level 16 pbb. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	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: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

LIC809 (FAS) - (06/04)

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