198003051-1-11-2023-33-CC-VMGA-CMZ2HP-20230111162503

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003051
Report Date: 01/11/2023
Date Signed: 01/11/2023 04:25:12 PM

Document Has Been Signed on 01/11/2023 04:25 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	198003051
ADMINISTRATOR:	MARYAM MASSOUDI		FACILITY TYPE:	850
ADDRESS:	1650 STONER CREEK		TELEPHONE:	6269653550
CITY:	CITY OF INDUSTRY	STATE: CA	ZIP CODE:	91748
CAPACITY:	48	CENSUS: 37	DATE:	01/11/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Director Maryam Massoudi		TIME COMPLETED:	04:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 01/11/2023, at 1:45 PM, Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with facility director, Maryam Massoudi, during the visit. There are of total of 2 classrooms for the preschool program. LPA observed children napping in the following rooms: Pre-K room(#1)- 19 children with 2 staff, PS room(#3) - 18 children with 3 staff. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility. Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Facility provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPA on 11/09/2022. On 12/01/2022, the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 11/19/2022. Faucet and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:  D – Sink Faucet in the Pre K room (7.800 UG/L) – Faucet currently not in use Director stated that the facility has not been using the faucet since COVID 19 pandemic started in 2020. The faucet is located inside the Pre K room. Director stated that the water has been shut off and was only turned on for the purpose of the lead testing. Facility has put a "do not use" sign on the sink faucet and made it further inaccessible by attaching and securing a plastic bag around the faucet. Page 1 of 2

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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 3

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 198003051
	VISIT DATE: 01/11/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The plumber has completely shut off the water. LPA took pictures of the faucet and sink. Director stated that she will have the vanity with the faucet replaced sometime next week and obtain a retest of it afterwards. LPA observed water dispensers readily available. Facility provides water via a pitcher or refills children's water bottles. A deficiency was cited to ensure that the water faucet noted will not be used as a drinking source for the children.

Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit
https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Type B deficiency 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.

Exit interview conducted and report was reviewed with the facility representative, Director Maryam Massoudi. A copy of PIN 21-21-CCP and appeal rights were provided to facility today. A notice of site visit was also provided and must remain posted for 30 days.

Page 2 of 2

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 01/11/2023 04:25 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 198003051
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/11/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/11/2023 Section Cited	1 2 3 4 5 6 7	101700.3(b)(1) California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater..., 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 is not met as evidenced by:	1 2 3 4 5 6 7	Director stated the outlet found to be in lead exceedance, in the Pre K room faucet, was last used in 2020. Director has covered the faucet..... posted appropriate "do not use" signage immediately around it. Director stated the fixture will be replaced and then having it retested once that is completed.
	8 9 10 11 12 13 14	Based on record review, the licensee did not comply with the directive above, as one outlet (outlet used for drinking water)out of eight outlets tested with an Action Level Exceedance (ALE). This poses an immediate Health and Safety risk to children in care.	8 9 10 11 12 13 14	The facility will provide a written statement on their plan to continue to ensure that the water sources will not be used as a drinking source by the POC date of 02/112023.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3