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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019321
Report Date: 02/27/2024
Date Signed: 02/27/2024 12:45:23 PM


Document Has Been Signed on 02/27/2024 12:45 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:ESGVJCC KOKORO NO SATO INFANT CENTERFACILITY NUMBER:
198019321
ADMINISTRATOR:PEARL OMIYAFACILITY TYPE:
830
ADDRESS:1203 WEST PUENTE AVENUETELEPHONE:
(626) 960-2566
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY:16CENSUS: 7DATE:
02/27/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Pearl Omiya, DorectorTIME COMPLETED:
01:00 PM
NARRATIVE
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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 a water fixture in the facility. LPA met with Pearl Omiya, Director during todays visit. Also present in the facility were 7 day care children and 8 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 and given on this date.

(SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 01/24/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

A– Drinking Fountain (26.00 UG/L) and A30 -- Drinking Fountain (5.50 UG/L) " 30 second Flushing"

Pearl stated the Drinking Fountain was never used prior to the testing and will still not be used. The class room where the drinking fountain "A" is located use to be the toddler class room and now is used as a preschool class room.

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (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: ESGVJCC KOKORO NO SATO INFANT CENTER
FACILITY NUMBER: 198019321
VISIT DATE: 02/27/2024
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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

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, Pearl Omiya, Director. Appeal 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 GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (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)
Page: 2 of 3
Document Has Been Signed on 02/27/2024 12:45 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: ESGVJCC KOKORO NO SATO INFANT CENTER
FACILITY NUMBER: 198019321

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2024
Section Cited
CCR
101700(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... (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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LPA observed that the water outlet “A” Drinking fountain was observed to be covered and a "do not use" sign and sticker was placed near it and director stated it will not be used at all, as it had never been used before. Photos taken and given
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This requirement is not met as evidenced by: Based on testing results provided by the facility with an Action Level Exceedance (ALE) of 26.00 ppb which poses/posed a potential health, safety, or personal rights risk to persons/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: Cynthia ReyesTELEPHONE: (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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