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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010126
Report Date: 03/29/2024
Date Signed: 03/29/2024 04:01:22 PM

Document Has Been Signed on 03/29/2024 04:01 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:RALPH M. PARSONS PRE-SCHOOLFACILITY NUMBER:
198010126
ADMINISTRATOR:MARGARET MENDOZAFACILITY TYPE:
850
ADDRESS:841 W. MARTIN LUTHER KING JR.TELEPHONE:
(213) 763-5119
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: DATE:
03/29/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Micha MimsTIME COMPLETED:
04:00 PM
NARRATIVE
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On 3/29/24, at 2:00 PM., Licensing Program Analysts (LPA) Claudia Kam and Katrina Chicote conducted an unannounced case management inspection and met with Director Micha Mims. This is a preschool facility that consists of 4 open classrooms. The hours of operation are Monday through Friday 7:00 AM - 6:00 PM. There were 40 children and 6 staff present during the inspection.

The purpose of today's inspection was to discuss the water lead test results. Results show that E water sources have action level exceedance (ALE) of lead: Room #1 – Sink Faucet used for drinking water have a lead exceedance of 25.7 points per billion (ppb), The faucet has been replaced and is now in compliance regarding lead. The classroom is not currently in use. LPAs observed the room is currently used for storage.

At 2:00 PM, LPA observed and tested all water sources with ALE. A deficiency was cited to ensure that the water faucets with the exceedance will not be used as a drinking source or food preparation source for the children. Citation issued under written directive section 100700.3(b) (2) that states “Licensees shall maintain a lead value at or below the Action Level of 5ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.”

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

Exit interview conducted and report was reviewed with the facility representative Micha Mims. A copy of the report and Appeal rights were given.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2024
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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Document Has Been Signed on 03/29/2024 04:01 PM - It Cannot Be Edited


Created By: Claudia Kam On 03/29/2024 at 02:01 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RALPH M. PARSONS PRE-SCHOOL
FACILITY NUMBER: 198010126

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/29/2024
Section Cited
HSC
100700.3(b)(2)

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Licensees shall maintain a lead value at or below the Action Level of 5ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.
This regulation was not met as evidenced by:

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LPA observed that the bubbler and faucet were replaced and deficiency has been cleared as of this day 3/29/24
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Based on review of lead reports. Licensee did not meet above regulation due to action level exceedance of lead. This poses a potential health and safety risk to 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:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2024


LIC809 (FAS) - (06/04)
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