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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019539
Report Date: 02/29/2024
Date Signed: 03/01/2024 03:49:48 PM


Document Has Been Signed on 03/01/2024 03:49 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:OLIVE TREE LEARNING ACADEMYFACILITY NUMBER:
198019539
ADMINISTRATOR:JUNG A KIMFACILITY TYPE:
850
ADDRESS:1318 S. BERENDO ST.TELEPHONE:
(213) 378-0512
CITY:LOS ANGELESSTATE: CAZIP CODE:
90006
CAPACITY:56CENSUS: 22DATE:
02/29/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Hyunjin KimTIME COMPLETED:
05:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with facility staff member Hyunjin Kim

During the inspection 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. Facility has already provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPA during a prior inspection.

On 09/08/2022, 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 08/20/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:
  • A sink faucet located in the kitchen of the main building for preschool license (14.0 UG/L) – This sink was not used since the results of the initial test. Sink was replaced by facility and retested on 12/10/22. Results dated 12/14/22 show that the ppb is no longer over 5.5 UG/L. New level observed in the results was 2.2 UG/L per documents provided during the inspection.

As documented in the previous inspection, the sink that was initially flagged was already replaced. Even before the sink was replaced, the facility did not use the sink for any type of food preparation or consumption since another sink that did not have exceedance was always available to use. .
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
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: OLIVE TREE LEARNING ACADEMY
FACILITY NUMBER: 198019539
VISIT DATE: 02/29/2024
NARRATIVE
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A deficiency was cited on attached LIC809-D. The deficiency listed on the following page were reviewed by the LPA and is being cited in accordance with California Code of Regulations Title 22. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

Facility was advised to post the test results for 5 years. Facility will have to redo the test 5 years from 12/10/2022.

During the visit a Proof of Correction (POC) letter was issued as the corrections were already made. The water source that was initially flagged of having exceedance on 08/20/2022 was already retested on 12/10/2022 per results provided by the facility.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Staff member Hyunjin Kim. Appeal rights discussed and explained.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 03/01/2024 03:49 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: OLIVE TREE LEARNING ACADEMY
FACILITY NUMBER: 198019539

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/29/2024
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 was not met as
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The sink was fixed and retested on 12/10/2022 and did not have exceedance levels. (2.2 ug/L). Clearance letter provided during this inspection.
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evidenced by the fact that testing results provided by the facility with an Action Level Exceedance (ALE) of 14.0, which poses/posed a potential health, safety or personal rights risk to persons 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: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
LIC809 (FAS) - (06/04)
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