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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422410
Report Date: 06/21/2024
Date Signed: 06/21/2024 03:36:34 PM

Document Has Been Signed on 06/21/2024 03:36 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LEARN AND PLAY MONTESSORI IRVINGTON, INC.FACILITY NUMBER:
013422410
ADMINISTRATOR/
DIRECTOR:		REYES, SHIRLEYFACILITY TYPE:
850
ADDRESS:40803 FREMONT BLVD.TELEPHONE:
(510) 573-0071
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 214TOTAL ENROLLED CHILDREN: 214CENSUS: 102DATE:
06/21/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:35 PM
MET WITH:Natasha AguliarTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On June 21st, 2024 at approximately 2:35pm, Licensing Program Analyst (LPA) April Wright conducted a Case Management inspection due to the facility's lead testing results. LPA met with the Senior Director Natasha Aguliar. Present during inspection were 102 preschool/toddler age children and 17 staff personnel including the Center Director Latasha Ware. LPA toured the facility for health and safety inspection.

LPA discussed with the Senior Center Director that Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test. Health and Safety (HSC) Code section 1597.16 authorizes the Department to implement and administer procedures for lead testing at CCCs through written instructions until it adopts regulations under the Administrative Procedure Act.

LPA discussed with the Center Director of the PIN 21-21-CCP - Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370 https://cdss.ca.gov/Portals/9/CCLD/PINs/2021/CCP/PIN-21-21-CCP.pdf

Fixtures K and WW (Children's bathroom right sink near Classroom #1 and exterior west left sink on play yard) Samples #2211447-021/022 and #2211447-097/098 had a Lead Action Level of Exceedance Response of more than 5.5 ppb. Senior Director Natasha Aguliar provided documentation that retesting was completed after faucets had been removed.

See LIC 809-D for deficiencies cited during today's inspection. Appeal rights provided. Exit interview was conducted with the Senior Director Natasha Aguliar. A notice of site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2024
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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Document Has Been Signed on 06/21/2024 03:36 PM - It Cannot Be Edited


Created By: April Wright On 06/21/2024 at 02:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARN AND PLAY MONTESSORI IRVINGTON, INC.
FACILITY NUMBER: 013422410

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2024
Section Cited
HSC
101700.3(b)(2)

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101700.3(b)(2) 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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LPA confirmed the Plan of Correction and submitted proof of permanent removal / remediation at the time of inspection on 6/21/2024.
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Fixtures K and WW (Children's bathroom right sink near Classroom #1 and exterior west left sink on play yard) Samples #2211447-021/022 and #2211447-097/098 had a Lead Action Level of Exceedance Response of more than 5.5 ppb which poses a potential health and safety risk to children 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:Chandra Charles
LICENSING EVALUATOR NAME:April Wright
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2024


LIC809 (FAS) - (06/04)
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