191600634-4-21-2023-30-CC-JLAO-CR4NTQ-20230421104503

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191600634
Report Date: 04/20/2023
Date Signed: 04/21/2023 10:45:11 AM

Document Has Been Signed on 04/21/2023 10:45 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ST JOHN'S PRESBYTERIAN NURSERY SCHOOL		FACILITY NUMBER:	191600634
ADMINISTRATOR:	WILSON,BRITTANY		FACILITY TYPE:	850
ADDRESS:	11000 NATIONAL BOULEVARD		TELEPHONE:	(310) 477-0507
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY: 71	TOTAL ENROLLED CHILDREN: 71	CENSUS: 31	DATE:	04/20/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Brittany Wilson		TIME COMPLETED:	01:15 PM

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 4/20/2023, Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced case management visit. LPA Laureano was greeted by Brittany Wilson, facility director. Director guided LPA on a tour of the facility. There were 31 preschool children and 7 staff members providing care and supervision, including director and administrative assistant. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test. Community Care Licensing was notified that lead water testing conducted at the facility on 3/9/2023 exceeded allowable limit for lead. Samples testing over 5.5 ppb/ug L and above is considered an exceedance. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE) and conduct an inspection. On 4/14/2023 LPA Laureano received notification from director Brittany Wilson, informing CCL that LEAD water testing has been completed in the facility and will prepared the following documents to submit to LPA: LIC 9275, LIC 9276, Facility Sketch (water faucets/outlets identified), pictures of fixtures and test results. The facility has been identified to have 1 water faucet/outlet located in the Kitchen Area, “C” with an Action Level Exceedance (ALE) in the amount of lead in water being 5.5pb, or greater. Facility Director confirmed the outlet/faucet identified as exceedance of lead shall remain inoperable. LPA Laureano observed water outlet/faucet identified with an Action Level Exceedance to be made inaccessible to the children in care; pictures were taken. LPA observed area to be taped, area is not an area accessible to the children in care. Director confirmed that children do not have access or are allowed in the space. LPA interviewed Director to ensure children do not have access to the identified sink/outlet that has been identified as exceedance of lead.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ST JOHN'S PRESBYTERIAN NURSERY SCHOOL	FACILITY NUMBER: 191600634
	VISIT DATE: 04/20/2023

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

Page 2
Children have access to water via Britta filter water pitcher in each classroom and water pitcher when children are outdoors. Children are encourage to bring in their own refillable water bottle to use throughout the day. LPA observed a filter water outdoors and in the classrooms; making water readily accessible to children in care.

Based on observation, interview and sampling records it has been determined that there was a violation of Licensing Regulation Title Division 12, Chapter 1, Subchapter 5 – California Lead Action Level at Child Care Centers 101700.3(b)(1), “A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance”. Lead water testing samples taken 3/9/2023 revealed that levels of lead were beyond allowable amount deemed by the State of California. This facility is being cited (1) deficiency during today’s visit 4/20/2023. This is a type B violation which poses a potential Health, Safety or Personal Rights risk to persons in care. In Accordance with California Code of Regulations. Refer to LIC 809-D.

LPA discussed Proof of Correction (POC) with Director. Faucet/water outlet “C”, identified with an Action Lead Exceedance of 5.5 ppb or over has been made inaccessible to the children in care. The outlet will not be accessible for use until a retest has occurred. A notification of letter was drafted and sent out by facility to parents with notification of cease of water outlet and remediation for planned for water outlets or alternative. Facility emailed LPA a copy of the letter via email on 4/14/2023. Facility will work on scheduling for a second test of identified outlet when repairs are completed. Director will email LPA a copy of the re-test summary once completed.

Instructions for required lead testing are outlined in PIN 21-21. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations Care Child Centers are expected to use an Environmental Laboratory Accreditation Program (ELAP), for lead testing. Accreditation from the California Environmental Laboratory Accreditation Program, known as an ELAP laboratory, is equipped to measure the amount of lead in a parts per billion (ppb) unit of measurement.

For more information, go to the California Childhood. Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb or call them at (510) 620-5600. Please see Provider Information Notice (PIN) 20-01-CCP for more information about lead toxicity prevention
Notice of Site Visit and copy of this report was provided to facility Director, Brittany Wilson.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3

Document Has Been Signed on 04/21/2023 10:45 AM - It Cannot Be Edited

Created By: Judy Laureano On 04/20/2023 at 12:38 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ST JOHN'S PRESBYTERIAN NURSERY SCHOOL	FACILITY NUMBER: 191600634
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/20/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/20/2023 Section Cited CCR 101700.3(b)(1)	1 2 3 4 5 6 7	California Lead Action Level at Child Care Care Center 101700.3(b)(1), A result with values of 5.5 ppb or greater shall be deemed an ActionLevel Exceedance	1 2 3 4 5 6 7	Facility has made outlet "C, identified with an Action Lead Exceedance of 5.5 ppb or over inaccessible until a retest has occurred. Director emailed LPA a copy of parent notification letter via email by 4/14/2023. Director will send LPA a copy of schedule repairs and re-test summary.
	8 9 10 11 12 13 14	Based on interviews, and review of lead water testing samples taken on 3/9/23 revealed that levels of lead were beyond allowable amount deemed by the State of California- 1 water outlets (C).This poses a potential 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:

Claudia Escobedo

LICENSING EVALUATOR NAME:

Judy Laureano

LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3