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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004841
Report Date: 01/10/2023
Date Signed: 01/10/2023 03:52:11 PM


Document Has Been Signed on 01/10/2023 03:52 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 CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:LONG BEACH CITY COLLEGE CDCFACILITY NUMBER:
198004841
ADMINISTRATOR:AMY BIGELOWFACILITY TYPE:
850
ADDRESS:4630 CLARK AVETELEPHONE:
(562) 938-4253
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:115CENSUS: 36DATE:
01/10/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Amy BigelowTIME COMPLETED:
04:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced case management inspection on January 10, 2023. LPA Birks met with Director Amy Bigelow who guided LPA on a tour of the facility. There were 36 children and nine (9) staff present during the inspection.

The purpose of today's inspection is to review and discuss the December 15, 2022 water lead test results received on January 5, 2022. The results indicate that one water source had action level exceedance of lead. The water faucet in the Redwoods classroom had a lead result of 6.4. Director Bigelow informed LPA Birks that the faucet and plumbing fixtures will be replaced with new plumbing fixtures. The faucet is not shut off however, staff keep the faucet covered with plastic so it is inaccessible to children. Director Bigelow indicated the room uses water from other sources in the facility (which were tested and have passing water levels).

At approximately 3:10pm LPA Birks took pictures of the water faucet. A deficiency was cited to ensure that the water faucet noted will not be used as a drinking source or food preparation source for children.

The deficiency listed on the following page was observed by the LPA and is being 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. Director Bigelow reiterated that the water source is not in use and submitted a written plan of correction during todays visit. Therefore, the citation is cleared.

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. Exit interview conducted with Director Amy Bigelow and a copy of Appeal Rights (LIC 9058) was discussed.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2023
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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Document Has Been Signed on 01/10/2023 03:52 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 CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: LONG BEACH CITY COLLEGE CDC
FACILITY NUMBER: 198004841

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/10/2023
Section Cited

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(b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level.

(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedence
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Director submitted plan of correction regarding repairs, faucit is covered in plastic and not in use.
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This requirement was not met as evidence by record review. Lead test results revealed one water source had an action level exceedence. This is a potential risk to the health and safety of 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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2023
LIC809 (FAS) - (06/04)
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