304270959-9-15-2022-06-CC-NKTN-CJAUPX-20220915154614

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270959
Report Date: 09/15/2022
Date Signed: 09/15/2022 03:46:25 PM

Document Has Been Signed on 09/15/2022 03:46 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CATALYST KIDS-OAK CREEK		FACILITY NUMBER:	304270959
ADMINISTRATOR:	LUZZI, AMY		FACILITY TYPE:	840
ADDRESS:	1 DOVE CREEK		TELEPHONE:	(949) 551-3275
CITY:	IRVINE	STATE: CA	ZIP CODE:	92618
CAPACITY:	105	CENSUS: 27	DATE:	09/15/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Sara Aguilera, Director		TIME COMPLETED:	03:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Nguyen Tran and LPA Romelia Castanon, conducted an unannounced Case Management visit. LPAs met with Director, Sara Aguilera to discuss the Lead Sampling Testing conducted on 07/08/22.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test. Community Care Licensing was notified that lead water testing conducted at the facility on 07/08/2022 failed allowable limit for lead. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedance (ALE).

Instructions for required lead testing are outlined in PIN 21-21-CCP. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations.

Child Care Centers are expected to use an Environmental Laboratory Accreditation Program (ELAP), for lead testing. Accreditation from the California Environmental Laboratory Accreditation Program, known as an ELAP laboratory, is equipped to measure the amount of lead in parts per billion (ppb) unit of measurement.

Facility representative was advised on 09/12/22 that the Lead Sample Report was to be posted. Staff stated the outlet B in room CC1 with a high levels of lead at 7.9, was made inoperable and the test result was posted on 07/27/2022. The Irvine Unified School District had sent staff to come to flush the faucet B starting 07/27/2022 for 4 weeks and the Forensic Analytical Consulting Services, returned to retest the water coming from faucet B on 08/27/2022. Faucet B was tested at 1.0 on 08/27/2022, and had met the requirement to be put back in usage. The result of the retest was posted on 09/15/2022. LPA verified that the test sample results were posted and verified documentation of the action that the facility had taken to fix outlet B. During the time of the faucet B was out of use, Director stated that the facility was using filtered water that came from a dispenser, which connected to an outlet that did not exceed the lead level, in room CC1. (Continue next page)

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 795-0859
LICENSING EVALUATOR NAME: Nguyen K Tran	TELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CATALYST KIDS-OAK CREEK	FACILITY NUMBER: 304270959
	VISIT DATE: 09/15/2022

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(Page 2 of Report)

Based on LPA's observation, interview with Director, review of facility's sketch and documentation regarding action taken to fix the identified outlet, the following violation was observed and is being cited in accordance with Written Directives Section 101700.3 (b)(1) California Lead Action Level at Child Care Centers, is being cited on the attached LIC 809D.

Exit interview conducted and report was reviewed with Director Sara Aguilera. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights and deficiency were explained. The Director was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

(End of Report)

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 795-0859
LICENSING EVALUATOR NAME: Nguyen K Tran	TELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 09/15/2022 03:46 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CATALYST KIDS-OAK CREEK	FACILITY NUMBER: 304270959
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/15/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type B 09/15/2022 Section Cited	1 2 3 4 5 6 7	101700.3 California Lead Action Level at Child Care Centers (b) Testing results...comparing to the Action Level. (1) A result with values of 5.5 part per billion or greater shall be deemed an Action Level Exceedance. This requirement was not met evidenced by:
	8 9 10 11 12 13 14	Record review of the lab report analysis water from Outlet B (7.9 parts per billion) taken on 08/27/2022 indicated levels of lead in exceedance, This poses a potential risk to the health, safety and personal rights of children in care.	8 9 10 11 12 13 14
	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: Rina Lopez	TELEPHONE: (714) 795-0859
LICENSING EVALUATOR NAME: Nguyen K Tran	TELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

LIC809 (FAS) - (06/04)

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