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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003766
Report Date: 03/26/2024
Date Signed: 03/26/2024 12:07:33 PM


Document Has Been Signed on 03/26/2024 12:07 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:NEW MONTESSORI SCHOOL, THEFACILITY NUMBER:
198003766
ADMINISTRATOR:GERALDINE SHAUGHNESSYFACILITY TYPE:
840
ADDRESS:15243 E. NELSON AVENUETELEPHONE:
(626) 369-4335
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:20CENSUS: 0DATE:
03/26/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Geraldine ShaughnessyTIME COMPLETED:
12:15 PM
NARRATIVE
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On 03/26/204, at 11:00 am Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced Case Management Lead Exceedance inspection. LPA met with Director, Geraldine Shaughnessy. A COVID 19 risk assessment was conducted. Per Director there are no school-age children at this time and LPA observed no children were present.

The purpose of today's inspection is to go over the water lead test results received on 02/29/2024. Results indicate that classroom sink water fixture “A”/"A30" located in the school-age classroom has a lead exceedance of 24 and then was flushed for 30 seconds according to the lead results emailed to the LPA during the visit the classroom sink was retested to a lead exceedance of 7.5, which exceed the regulation of less than 5.5 parts per billion. During the visit, LPA took photos of the classroom sink. According to the Executive Director, Gamal Tawfik the sink was repaired and retested and will email the LPA the new results.

The documentation of LIC 9275, LIC 9276, lead results, and facility sketch were emailed by the Executive Director on 5/19/2023.

On 03/25/2023 licensee failed to maintain a lead value at or below the Action Level for water lead testing which resulted with values of 5.5 ppb or greater for the classroom sink fixture “A”/"A30" water outlet. Water testing results identified with Action Level Exceedance as defined in Written Directives section 101700.3 are not deemed safe to drink.

LPA advised Director and Executive Director that lead testing results must be posted outside for parents to view until the next testing is conducted every 5 years from the date of the initial test. According to Executive Director who LPA spoke with over the phone indicated that they will be posting.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/26/2024
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NEW MONTESSORI SCHOOL, THE
FACILITY NUMBER: 198003766
VISIT DATE: 03/26/2024
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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.

LPAs 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.



A deficiency was cited on attached 809D. The deficiency listed on the following page were reviewed by the LPAs and is being cited in accordance with California Code of Regulations Title 22. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given to licensee and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Geraldine Shaughnessy.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/26/2024 12:07 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: NEW MONTESSORI SCHOOL, THE
FACILITY NUMBER: 198003766

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/26/2024
Section Cited
CCR
101700.3

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101700.3 California Lead Action Level at Child Care Centers. "Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of the Written Directives, for the health and safety of children in care"
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Per Exectuive Director Classroom Sink "A" and "A30" water outlet has been repaired and retested. The retesting results will be emailed to LPA. LPA viewed that the results indicate that the "A" and "A30" are the same fixture and was tested twice after a 30 second flush.
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This requirement is not met as evidenced by: Testing results provided by the facility with an Action Level Exceedance (ALE) of 24 on the "A" water outletand "A30" Action Level Exceedance (ALE) 7.5, which poses/posed a potential health, safety or personal rights risk to persons 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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 03/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/26/2024
LIC809 (FAS) - (06/04)
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