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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191225998
Report Date: 03/24/2023
Date Signed: 03/24/2023 12:18:20 PM

Document Has Been Signed on 03/24/2023 12:18 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GLENDALE C. C. CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191225998
ADMINISTRATOR:JEANETTE TASHIROFACILITY TYPE:
850
ADDRESS:1500 N. VERDUGO ROADTELEPHONE:
(818) 549-9442
CITY:GLENDALESTATE: CAZIP CODE:
91208
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 21DATE:
03/24/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Jeanette Tashiro, DirectorTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 03/24/2023. A COVID 19 risk assessment was conducted prior to entering the facility. LPA arrived at the facility at 10:55 AM and met with Jeanette Tashiro, director who provided a tour of the facility. During this inspection Clifford Gimbert, Assistant Project Manager stop by in the facility to provide a copy of facility sketch with sample sites. There were 21 children and 6 staff present during the inspection.

During the inspection LPA reviewed 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 representative 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. Facility provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPAs.

On 03/08/2023, the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 02/17/2023. Results indicated that D water source, water fountain located on the west side of CDC in infant/toddler play yard between Dragon classroom and Koala classroom with 5.5 ppb or greater lead exceedance levels.

Per director, outside water fountain which is located between Dragon and Koala classrooms, has not been used since Covid, 03/2020 and it was covered. Per director, water has been disconnected in water source D since 10/17/2022. LPA observed D water source was inaccessible to the children and it was covered with cloth material. (Pictures were taken).

Per Clifford Gimbert, it will be retested in order to be accessible to the children.
REPORT CONTINUES ON NEXT PAGE 1 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2023
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GLENDALE C. C. CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191225998
VISIT DATE: 03/24/2023
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 An Advisory Violation was issued on this date based on Title 22 Regulation 101700.3 California Lead Action Level at Child Care Centers.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director, Jeanette Tashiro at 12:40 PM.


REPORT END 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC809 (FAS) - (06/04)
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