198018225-4-18-2023-33-CC-MJAA-CQZMGZ-20230418093646

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018225
Report Date: 04/18/2023
Date Signed: 04/18/2023 09:37:00 AM

Document Has Been Signed on 04/18/2023 09:37 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:	PARA LOS NINOS HEAD START - HOLLYWOOD		FACILITY NUMBER:	198018225
ADMINISTRATOR:	ANGELA CAPONE		FACILITY TYPE:	850
ADDRESS:	5000 HOLLYWOOD BLVD		TELEPHONE:	(213) 250-4800
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90027
CAPACITY:	60	CENSUS: 32	DATE:	04/18/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Vanessa Quezada, Area Supervisor		TIME COMPLETED:	09:50 AM

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On 04/18/2023, at 8:05 AM, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with Area Supervisor, Vanessa Quezada, who guided LPA on a tour of the facility. LPA observed 32 children in care with 6 staff members. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility.

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 will provide facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPA on via email to LPA by COB.

On 03/31/2023, 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 03/11/2023. The drinking fountain was tested twice on 03/11/2023 and reported with 5.5 ppb or greater lead exceedance levels were as follows:

C – Drinking Fountain (14 UG/L) – Not in use (Initial test without flushing)

C30 - Drinking Fountain (8.4 UG/L) - Not in use (tested after flushing)

Area Supervisor stated that the drinking fountain located in the big playground outside of room 25 has never been used for drinking. The drinking fountain had already had lead exceedance levels and was retested on 03/11/2023. Per Area Supervisor she was flushing the drinking fountain as directed.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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: PARA LOS NINOS HEAD START - HOLLYWOOD	FACILITY NUMBER: 198018225
	VISIT DATE: 04/18/2023

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Area Supervisor stated that the facility has always provided Arrowhead water for children to drink, and provided LPA with a copy of the contract/bill dated back to 2014. Facility has put an "out of order/do not use" sign on and around the drinking fountain and made it further inaccessible by attaching and securing shrink wrap around the outlet.

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, please see LIC809D.

An exit interview conducted and a copy of this report was provided to, Area Supervisor Vanessa Quezada along with Notice of Site Visit and Appeal Rights.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/18/2023 09:37 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: PARA LOS NINOS HEAD START - HOLLYWOOD	FACILITY NUMBER: 198018225
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/18/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/19/2023 Section Cited	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..., 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 was not met as evidence by	1 2 3 4 5 6 7	Per Site Supervisor, will continue to make the fountains inaccessible while communicatiing her her comany about perminant solutions (shutting the water off, removing fountains or adding a filter).
	8 9 10 11 12 13 14	Based on record review, the licensee did not comply with the directive above, as two outlets (outlet used for XX) out of four outlets tested with an Action Level Exceedance (ALE). This poses/posed an immediate/ a potential Health and Safety risk to 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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

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