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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570658
Report Date: 08/31/2023
Date Signed: 08/31/2023 02:35:35 PM

Document Has Been Signed on 08/31/2023 02:35 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:EMERSON/CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191570658
ADMINISTRATOR:KYM ALLENFACILITY TYPE:
850
ADDRESS:635 LINCOLN AVENUETELEPHONE:
(909) 622-4642
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 58TOTAL ENROLLED CHILDREN: 58CENSUS: 5DATE:
08/31/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Kym Allen, DirectorTIME COMPLETED:
01:55 PM
NARRATIVE
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On 08/31/2023 at 12:34PM, Licensing Program Analyst (LPA) Thelma Razo conducted an unannounced Case Management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. A COVID 19 risk assessment was conducted prior to entering the facility. LPA met with facility Director Kym Allen during the visit. There were 5 children napping with 2 teachers at the time of visit. Facility was within ratio and capacity.
Analyst 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 Director during the inspection. Per AB 2370, all CCCs that are 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 9275, LIC9276 and LIC999 to LPA during this inspection. On 12/30/2022, 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 12/10/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EMERSON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191570658
VISIT DATE: 08/31/2023
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  • Drinking fountain in the kitchen - E (11 UG/L) – LPA observed drinking faucet was retested and now in compliance.
Director stated that the facility has not been using the drinking water even before the lead testing. Children use Brita filtered water and uses little dixie cups.

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 today. See LIC809D.

A notice of site visit was also provided 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 with Director Kym Allen. Report and Appeal Rights were given.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/31/2023 02:35 PM - It Cannot Be Edited


Created By: Thelma Razo On 08/31/2023 at 01:22 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EMERSON/CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191570658

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2023
Section Cited
CCR
101700.3(b)(1)

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California Lead Action Level at Child Care Centers. (b) Testing results with fractional readings of parts per billion (ppb) 0.5 ppb or greater shall be rounded 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 requirement was not
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During this visit, LPA Razo the drinking fountain was capped and was permanently removed.
Deficiency was corrected.
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met as evicdenced by drinking fountain by the kitchen tested with an Action Level Exceedance (ALE) of 11. This 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:Ana Chico
LICENSING EVALUATOR NAME:Thelma Razo
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2023


LIC809 (FAS) - (06/04)
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