198008125-2-3-2023-33-CC-NTCG-CNPPXB-20230203104203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198008125
Report Date: 02/03/2023
Date Signed: 02/03/2023 10:42:11 AM

Document Has Been Signed on 02/03/2023 10:42 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	PICO UNION PRESCHOOL CENTER/PARA LOS NINOS		FACILITY NUMBER:	198008125
ADMINISTRATOR:	ANGELA CAPONE		FACILITY TYPE:	850
ADDRESS:	1521 W. THIRD ST.		TELEPHONE:	(213) 250-4800
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90017
CAPACITY:	72	CENSUS: 45	DATE:	02/03/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Cesia Romero - Site Supervisor		TIME COMPLETED:	10:50 AM

NARRATIVE

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. Upon Arrival at 9am, LPA met with Site Supervisor Cesia Romero, who guided LPA on a tour of the facility. There were children present during the time of the inspection.

Census was taken. LPA observed 45 children with 7 staff members.

LPA 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 during today’s inspection.

On 10/15/2022, 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 10/15/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

I - "Outdoor Room 2 Water Fountain" - test result was 14.00ppb

Director states that the water fountain has not been in use for about 3 years. Children are provided water through large Sparklett water jug dispensers, located in each classroom. During the inspection, LPA observed the affected water fountain was wrapped with plastic in order to prevent use and a sign has been placed on the fountain stating "Out of Use." Per Site supervisor, they have already replaced the fountain parts and are waiting for approval for another company to come and retest the facility.
REPORT CONTINUES PAGE 1 of 2

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

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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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: PICO UNION PRESCHOOL CENTER/PARA LOS NINOS	FACILITY NUMBER: 198008125
	VISIT DATE: 02/03/2023

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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

The deficiency listed on the following page were 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.

Notice of Site Visit was provided and must remain post for 30 consecutive days. A copy of PIN 21-21-CCP and appeal rights were provided to facility today.

An exit interview conducted with Cesia Romero, at 10:30am, and a copy of this report was provided.

END OF REPORT PAGE 2 of 2

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/03/2023 10:42 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PICO UNION PRESCHOOL CENTER/PARA LOS NINOS	FACILITY NUMBER: 198008125
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/03/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/10/2023 Section Cited	1 2 3 4 5 6 7	101700.3 (b)(1) Testing results with fractional ppb readings of 5.5 ppb or greater shall be rounded up to the nearest whole number...(1) A result with values of 5.5 or greater shall be deemed and Action Level Exceedance This requirement was not met as evidence by:	1 2 3 4 5 6 7	Per Licensee, they will submit written plan for the consumption of water on site, submit invoice for Sparklett jugs, and submit a copy of the work order/invoice for the replacement of the water outlets that was conducted. They will submit by POC date.
	8 9 10 11 12 13 14	Based on record review, the facility has 1 water outlet that has a lead exceedance of 14.00ppb. This poses a potential risk to the health, safety, and personal rights 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
	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: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

LIC809 (FAS) - (06/04)

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