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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371210
Report Date: 11/10/2022
Date Signed: 11/10/2022 02:21:08 PM


Document Has Been Signed on 11/10/2022 02:21 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:LEPORT-IRVINE WOODBRIDGEFACILITY NUMBER:
304371210
ADMINISTRATOR:GIMBI GOROSPE, CHRISTINAFACILITY TYPE:
850
ADDRESS:26 LAKE ROADTELEPHONE:
(949) 551-9020
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:118CENSUS: 53DATE:
11/10/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Christina Gimbi, director TIME COMPLETED:
02:30 PM
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On 11/10/2022 Licensing Program Analyst (LPA) Stella Gutierrez conducted an unannounced Case Management visit. LPA met with Director, Christina Gimbi to discuss the Lead Sampling Testing conducted on 10/21/2022. Director was advised on 09/08/22 that the Lead Sample Report was to be posted. LPA confirmed that Director had posted the Lead Sample Report.

Director stated the outlets A and B with high levels of lead are inoperable. LPA, Gutierrez observed there to be dishes in outlet A. Staff #1 stated that the outlet is not used for drinking or washing the dishes and that they only use the sink to store the dishes then later transfer dishes to another sink to wash. LPA advised the director to not use the sink for storage purposes and that the sink is to be made off limits by tape. LPA was observed B outlet to be off limits and inaccessible. LPA Gutierrez verified that the facility made the faucets/outlets that tested with high levels of Lead inoperable via tape on the sink, around and a sign “DO NOT USE” before departure. The facility will continue to provide the children water from the Brita filtered water, which is filled from another sink in the facility. The children use the water from the Brita filter container to fill their water bottles to use as needed indoor and outdoor.
Director stated they have contacted Spring Edu Group, who conducted the sampling on 10/21/2022, immediately made the identified outlets inoperable and posted the test result as soon as they received the test result from Spring Edu Group on 10/31/2022 . The facility maintenance team has replaced the faucets, and the Spring Edu Group will schedule to come back out to re-test before the faucet can be putting back into use.
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 10/21/2022 failed allowable limit for lead. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE).

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2022
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: LEPORT-IRVINE WOODBRIDGE
FACILITY NUMBER: 304371210
VISIT DATE: 11/10/2022
NARRATIVE
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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.

Care Child 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.

Based on LPA's observations, interview with Director, Christina Gimbi record review, the following violation was observed and is being cited in accordance with California Code of Regulations Title 22, Division 12, Chapter 3, Section 101700.3 California Lead Action Level at Child Care Centers is being cited on the attached LIC 809D.



Exit interview conducted with Director Christina Gimbi. Appeal Rights and deficiency were explained. The Licensee 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.

Director was informed that the "Notice of Site Visit" must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00.

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SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/10/2022 02:21 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: LEPORT-IRVINE WOODBRIDGE
FACILITY NUMBER: 304371210

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/22/2022
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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Based on lab report analysis water from Outlet B (7.8 parts per billion) and same Outlet C (6 parts per billion) taken on 10/21/2022 indicate levels of lead in exceedance.
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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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2022
LIC809 (FAS) - (06/04)
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