198015694-2-27-2024-33-CC-CRES-D2V32P-20240227165216

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015694
Report Date: 02/27/2024
Date Signed: 02/27/2024 04:52:32 PM

Document Has Been Signed on 02/27/2024 04:52 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHERRY BLOSSOM CHILD CARE & PRESCHOOL		FACILITY NUMBER:	198015694
ADMINISTRATOR:	LYNN MARROQUIN		FACILITY TYPE:	850
ADDRESS:	906 S. GRAND AVENUE		TELEPHONE:	(626) 335-5500
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY:	55	CENSUS: 27	DATE:	02/27/2024
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	03:55 PM
MET WITH:	Martha Alvarez Director		TIME COMPLETED:	05:15 PM

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On February 27, 2024 Licensing Program Analysts (LPA) Cynthia Reyes conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in water fixtures in the facility. LPA met with Martha Alvarez, Director during todays visit. Also present in the facility were 27 day care children and 3 teachers/staff. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility.

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) 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 copy of the lead results from the SWRCB was provided and posted on the parent board.

Facility provided a copy of the facility sketch LIC 999 and required forms LIC 9276, LIC 9275 and other forms attached to the water sampling. Photos taken on this date.

(SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 12/07/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

E– Left side sink (11.000 UG/L) and F--Right side sink (5.9 UG/L). 2 sinks exceedance out of 8 sinks in the center that were checked.

Martha stated the 2 sinks ("E" and "F") are never used for drinking even prior to the testing and will not be used at all for drinking. Both sinks will be replaced by a new lead free faucet and porcelain covered cast iron utility sink and retested once installed.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

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: CHERRY BLOSSOM CHILD CARE & PRESCHOOL	FACILITY NUMBER: 198015694
	VISIT DATE: 02/27/2024

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Licensee provided LPA with a receipt from a plumber who had sink "B" and "C" replaced in error and who will need to replace the exceedance sinks "E" and "F". Martha states will send photos of the plumber replacing the correct 2 sinks by the plan of correction 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

A Type B deficiency is being cited under California Code of Regulations Title 22, 101700(b)(1), see LIC809D.

Exit interview conducted and report was reviewed with the facility representative Martha Alvarez DirectorAppeal rights were provided to facility on this date. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/27/2024 04:52 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CHERRY BLOSSOM CHILD CARE & PRESCHOOL	FACILITY NUMBER: 198015694
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/27/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/29/2024 Section Cited CCR 101700.3(b)(1)	1 2 3 4 5 6 7	101700.3(b)(1) California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater... (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.	1 2 3 4 5 6 7	Martha stated the 2 sinks ("E" and "F") are never used for drinking even prior to the testing and will not be used at all for drinking. Both sinks will be replaced by a new lead free faucet and porcelain covered cast iron utility sink and retested once installed by the POC date of 03/29/2024. Submit Proof.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: Based on testing results provided by the facility with an Action Level Exceedance (ALE) of 2 sinks (11.000 and 5.9. ppb) which poses/posed a potential health, safety, or personal rights risk to persons/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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

LIC809 (FAS) - (06/04)

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