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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014558
Report Date: 03/08/2024
Date Signed: 03/08/2024 02:46:58 PM


Document Has Been Signed on 03/08/2024 02:46 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:BPUSD-KENMORE ELEMENTARY SCHOOLFACILITY NUMBER:
198014558
ADMINISTRATOR:RICARDO RIVERAFACILITY TYPE:
850
ADDRESS:3823 KENMORE AVENUETELEPHONE:
(626) 962-3311
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:24CENSUS: 14DATE:
03/08/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Nancy Sanchez, Program ManagerTIME COMPLETED:
03:15 PM
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On 03/8/2024, at 1:30 PM, Licensing Program Analyst (LPAs) Mary Silva and Saul Valenzuela conducted an unannounced case management lead testing exceedance inspection for an Action Level Exceedance (ALE) detected in four water fixtures in the facility. LPA(s) were greeted by Ursula Sanchez, teacher. Program Manager Nancy Sanchez and Education Supervisor Guillermina Solis led LPA(s) on a tour of the facility. Also present in the facility were 14 daycare children and 2 teachers/staff. Facility was within ratio & capacity.
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). 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.

On 02/08/2024, 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 12/02/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

Sample Site A – Main kitchen food prep (18.000 UG/L) - remediated
Sample Site B – Main Kitchen left 3-bay sink (30.000 UG/L) - remediated
Sample Site C – Main Kitchen right 3-bay sink (24.000 UG/L) - remediated
Sample Site I – Main Kitchen tilt sink (8.000 UG/L) – faucet was capped.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BPUSD-KENMORE ELEMENTARY SCHOOL
FACILITY NUMBER: 198014558
VISIT DATE: 03/08/2024
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Program Manager stated the facility did not used the faucets in main kitchen when it tested for lead exceedance. The faucet in the kitchen was used for food prep. Per program manager breakfast, lunch, and snack were being provided by Tracy Elementary when water outlets A, B, C, I tested with a lead exceedance above 5.5 ppb. Facility remediated outlets A, B, C and capped I. Program manager indicated outlets labeled A, B, C were retested on 2/16/2024, and results were provided on this date. Facility will provide the required forms LIC 999, LIC 9276, and LIC 9275 by the POC due date.

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

Based on the LPA’s observations and records reviews, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.


Exit interview conducted, appeal rights were given, and report was reviewed with the program manager, Nancy Sanchez.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/08/2024 02:46 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: BPUSD-KENMORE ELEMENTARY SCHOOL
FACILITY NUMBER: 198014558

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/08/2024
Section Cited
CCR
101700.3(b)(1)

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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:
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Per program manager the outlets labeled A, B, and C were remediated and retested on 2/16/2024. Outlet labeled I was capped. Facility will provide LIC 999, LIC 9275, and LIC 9276 by POC due date.
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Based on record review, the licensee did not comply with the directive above, as four outlet (outlet used for hand washing) out of ten outlets tested with an Action Level Exceedance (ALE). 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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
LIC809 (FAS) - (06/04)
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