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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019396
Report Date: 02/27/2024
Date Signed: 02/27/2024 04:38:30 PM


Document Has Been Signed on 02/27/2024 04:38 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:AZUSA USD/VALLEYDALE CSPPFACILITY NUMBER:
198019396
ADMINISTRATOR:JENNY LEFACILITY TYPE:
850
ADDRESS:700 S LARK ELLENTELEPHONE:
(626) 815-4700
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY:60CENSUS: 15DATE:
02/27/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Principal Horacio TrejoTIME COMPLETED:
04:00 PM
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On 02/27/2024 Licensing Program Analyst (LPA) Mary Silva conducted an unannounced case
management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA
met with principal Horacio Trejo, to whom the reason of the visit was explained. Census was taken. LPA observed 15 children and two 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.

Facility provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPA on 01/28/24.
On 11/03/2023, 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 10/24/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead
exceedance levels were as follows:

A – Sink Faucet located in the Teacher’s Work Room(7.690 UG/L) – Faucet currently not in use

Principal stated that the facility uses the faucet by staff to prepare for arts activities. The faucet’s use was terminated when the facility was informed that it was exceeding acceptable levels. Facility has put a black plastic bag around the sink faucet and making it inaccessible to staff. Principal stated Teacher’s Room is inaccessible to children in care. Children bring water from home and facility has water bottles in the classroom for drinking.
_____________________________________Page 1____________________________________
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
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: AZUSA USD/VALLEYDALE CSPP
FACILITY NUMBER: 198019396
VISIT DATE: 02/27/2024
NARRATIVE
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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

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 and report was reviewed with the facility representative, Principal Horacio Trejo. A copy of PIN 21-21-CCP and appeal rights were provided to facility today. A notice of site visit was also provided and must remain posted for 30 days.

_________________________________Page 2_________________________________________
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
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 04:38 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: AZUSA USD/VALLEYDALE CSPP
FACILITY NUMBER: 198019396

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2024
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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Principal stated the outlet found to be in lead exceedance, is located in the teacher's work room and is inaccessible to children. Per principal outlet is covered, remediated and will be-retested by POC due date.

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Based on LPA's observation and interview, the facility did not comply with the directive above, as one outlet (outlet used by staff to prepare for art activities) out of five outlets tested with an Action Level Exceedance (ALE). This poses an 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: 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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