<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191501775
Report Date: 10/11/2024
Date Signed: 10/11/2024 12:00:55 PM

Document Has Been Signed on 10/11/2024 12:00 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:CLAREMONT UNITED CHURCH OF CHRIST ECCFACILITY NUMBER:
191501775
ADMINISTRATOR/
DIRECTOR:		KNIGHT, KRISTYFACILITY TYPE:
850
ADDRESS:233 W HARRISON AVETELEPHONE:
(909) 624-2916
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 45DATE:
10/11/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Kristy KnightTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/11/2024, at 9:15 am Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced Case Management Lead Exceedance inspection. LPA met with Director, Kristy Knight. A COVID 19 risk assessment was conducted. LPA took a census of 45 children with 8 staff members and confirmed their clearance.

On 09/16/2024, 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 12/27/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

Results indicate that drinking fountain water fixture “I" located in the preschool playground had a lead exceedance of 11.00 ppb and after a 30 second flush it resulted a 1.10 ppb, however due to the initial exceedance of 11 ppb, that exceeds the regulation of less than 5.5 parts per billion. During the visit, LPA took photo of the drinking fountain. According to the Director, the fountain was capped off on 3/31/2023 and is no longer in use. Children bring water bottles from home and Brita Water Pitcher’s is used to refill their bottles. Bottled water is used to fill the Brita Water Pitchers and are brought to the playground for the children to have drinking water available.

The documentation of LIC 9275, LIC 9276, lead results, and facility sketch were emailed by the Director on 1/1/2023 and Director also sent a photo of the water fountain fixture “I” capped off on 3/31/2023.

LPA observed that test results are posted on the board for parents to view until the next testing is conducted every 5 years from the date of the initial test.

page 1 of 2
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2024
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 3
Document Has Been Signed on 10/11/2024 12:00 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 10/11/2024 at 11:03 AM
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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CLAREMONT UNITED CHURCH OF CHRIST ECC
FACILITY NUMBER: 191501775

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/11/2024
Section Cited
CCR
101700.3(b)(1)

1
2
3
4
5
6
7
California Lead Action Level at Child Care Centers. (b) Testing results
with...readings of 0.5 ppb or greater..., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirment was not met as evidence by:
1
2
3
4
5
6
7
Per director the drinking fountain water fixture"I" with lead exceedance was capped off on 03/31/2023. LPA took photo of the capped off fountain. Children bring water from home and are provided refills from bottled water.
8
9
10
11
12
13
14
Based on record review, the facility had a high lead exeedance of 11.00 UG/L on drinking fountain fixture "I" that poses a potiental health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Ana Chico
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2024


LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CLAREMONT UNITED CHURCH OF CHRIST ECC
FACILITY NUMBER: 191501775
VISIT DATE: 10/11/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Childcare 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.

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

A deficiency was cited on attached 809D. The deficiency listed on the following page were reviewed by the LPA and is being cited in accordance with California Code of Regulations Title 22. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director, Kristy Knight.

page 2 of 2
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3