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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701286
Report Date: 01/04/2023
Date Signed: 01/04/2023 11:47:53 AM


Document Has Been Signed on 01/04/2023 11:47 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:MONTESSORI AMERICAN SCHOOLFACILITY NUMBER:
376701286
ADMINISTRATOR:YOLANDA ALVAREZFACILITY TYPE:
850
ADDRESS:3604 BONITA ROADTELEPHONE:
(619) 422-1220
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:96CENSUS: 83DATE:
01/04/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Yolana AlvarezTIME COMPLETED:
11:10 AM
NARRATIVE
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On January 4th, 2023 at 10:05 AM, Licensing Program Analyst (LPA) JoAnn Legaspi conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of lead detected in a facility water fixture. LPA met with Director Yolanda Alvarez. The purpose of the inspection was explained, and facility was toured. Present in facility were eighty-three (83) children with ten (10) staff.

LPA discussed the 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.

The Department obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), on 12/20/2022.

On 12/16/2022, the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report (testing #1406) indicated the facility was inspected and samples were collected on 12/08/2022. The outlets/fixtures reported with 5.5 ppb or greater lead exceedance levels were as follows:

B – Drinking Playground Fountain. Fountain has been removed from service for about 2.5 years.

Director Alvarez reported the playground drinking fountain is off-limits for children. Director Alvarez stated the fountain has not been utilized for drinking water or food preparation for about 2.5 years. The director stated all staff have been made aware of the ALE in the drinking fountain and will not utilize the fountain for drinking water or food prep. An ‘out of service’ sign is on the fountain and the water has been turned off.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONTESSORI AMERICAN SCHOOL
FACILITY NUMBER: 376701286
VISIT DATE: 01/04/2023
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.

LPA informed Director Alvarez that this report dated 01/04/2023 documents one (1) Type B citation on the attached 809-D.

LPA advised Director Alvarez that parents must be notified of the lead exceedances. Licensees shall post testing results, in a location consistent with the requirements of subsection (b) of section 1596.8595 of the Health & Safety Code, for parents and families to view at the facility within 24 hours of receiving the results from the Department.

Exit interview conducted and report was reviewed with Director Alvarez. A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/04/2023 11:47 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108


FACILITY NAME: MONTESSORI AMERICAN SCHOOL
FACILITY NUMBER: 376701286

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/03/2023
Section Cited

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101700.3 California Lead Action Level at Child Care Centers - 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 ... 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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The facility has made the outlet that tested with an ALE out of service and posted appropriate signage. Director said they will remediate and eventually remove the impacted outlet. The fixture is to be retested by a certified water sampler and a follow-up water sample must be taken following the protocol outlined in Written Directives, Section 101705. Director said that children in care are given alternative potable

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Based on record review, the licensee did not comply with the directive above, B outlet/drinking fountain is not used for drinking and/or food preparation tested with an Action Level Exceedance (ALE). This poses a potential Health and Safety risk to children in care.
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water, by using alternate outlets/bottled water/water cooler, while waiting to replace the outlet. Director said parents will be notified of the lead exceedances via email. Director stated the POC will be provided to the San Diego Regional Office no later than 02/03/2023 (within 30 days)


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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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
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