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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370896
Report Date: 11/09/2022
Date Signed: 11/10/2022 07:58:13 AM


Document Has Been Signed on 11/10/2022 07:58 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:EARLY LEARNING PRESCHOOLFACILITY NUMBER:
304370896
ADMINISTRATOR:GUERRERO, LEONORFACILITY TYPE:
850
ADDRESS:4539 CERRITOS AVENUETELEPHONE:
(562) 493-3921
CITY:CYPRESSSTATE: CAZIP CODE:
90630
CAPACITY:68CENSUS: 25DATE:
11/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Leonor Guerrero, DirectorTIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced Case Management Inspection, met with director Leonor Guerrero to discuss the Lead Sampling testing conducted. A physical plant walk through was conducted and census of staff/children was taken in individual classrooms. During the inspection there were 25 children present and 3 staff. During the inspection, LPA Valencia ensured that the director is aware of the Lead Sample Report required to be posted.

Director stated that they reported a single faucet in Room #1, that reported exceedance lead level. One faucet in the classroom #1, has been made inoperable and off limits, and LPA verified this during the inspection. Proof of the correction along with other LIC forms requested will be submitted to LPA within 30 days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 11/10/2022 07:58 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868


FACILITY NAME: EARLY LEARNING PRESCHOOL
FACILITY NUMBER: 304370896

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/09/2022
Section Cited

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101700.3 California Lead Action Level at Child Care Centers (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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The above was not met as evidenced by:
The facility registered a single faucet in the facility with lead levels exceeding 5.5ppb.
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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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2022
LIC809 (FAS) - (06/04)
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