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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670847
Report Date: 03/02/2023
Date Signed: 03/02/2023 12:16:17 PM

Document Has Been Signed on 03/02/2023 12:16 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LONG BEACH CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670847
ADMINISTRATOR:MARIE GAINESFACILITY TYPE:
850
ADDRESS:2222 OLIVE AVETELEPHONE:
(562) 426-8897
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 12DATE:
03/02/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Laura Sydney, Site SupervisorTIME COMPLETED:
12:15 PM
NARRATIVE
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 On March 2, 2023, at 11:00AM., Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced case management inspection and met with Laura Sidney, Site Supervisor. This is a preschool program. The Preschool program consists of 3 open classrooms. The hours of operation are Monday through Friday – 7:00am to 6:00pm. There were 12 children and 3 staff present during the inspection.
The purpose of today's inspection was to discuss the water lead test results. Results show that 1 water sources have action level exceedance (ALE) of lead: Outside Playground Fountain in the Preschool area used for drinking water has a lead exceedance of 7.2 parts per billion (ppb). This drinking fountain was used by children up until lead testing on 12/01/2022. On 12/13/2022, the center received the results of the ALE. The center turned off the water and taped off the fountain making it inaccessible for children’s use. LPA took photos. At 11:45AM, LPA observed and tested the water source with ALE. Water sources were observed to be turned off and inaccessible to children. Per Site Supervisor, the children are drinking unfiltered tap water dispensed from the kitchen sink area at 2230 Olive Ave, next door to the center. The center fills up the water coolers and then cups are provided, water is readily available to children. LPA reminded Director that lead results must be posted where they are accessible to parents. The center will post the results on the parent board. The center will create a notification letter and send to the parent of the lead results and correction process. The letter will be sent out today (03/02/23). Per Site Supervisor, the center is actively trying to schedule an appointment to repair the affected water source. The correction plan is to replace the galvanized pipes and change to copper. Also, Install a low lead water fixture with a filter. The repairs estimated date of correction will be expected to be complete by April 1, 2023. A deficiency was cited to ensure that the affected water source- playground drinking fountain with the exceedance will not be used as a drinking source or food preparation source for the children. The kitchen water resources were tested at 2230 Olive Ave, Long Beach and were not over lead exceedance levels. The deficiency listed on the following page was observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared by 04/01/2023 to protect the children’s health & safety.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LONG BEACH CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670847
VISIT DATE: 03/02/2023
NARRATIVE
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A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and the Plan of Correction was reviewed and developed with the Site Supervisor. A copy of this report and appeal rights were discussed and provided to Site Supervisor Laura Sidney, whose signature on this form confirm receipt of these documents.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/02/2023 12:16 PM - It Cannot Be Edited


Created By: Dayna Chambers On 03/02/2023 at 12:06 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONG BEACH CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670847

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/02/2023
Section Cited
CCR
101700.3(b)(1)

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101700.3(b)(1)
(b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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Water sources showing ALE have been shut off and children do not have access. Lead testing repairs will be completed by April 1, 2023 by replacing the galvanized pipes and change to copper. Also, install a low lead water fixture with a filter in order to correct the lead exceedance. Site Supervisor will send LPA an email
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This requirement was not met as evidence by:
Based on record review the licensee did not ensure water source at facility meet lead requirements. Lead test results showed that one water source has an action level exceedance of 7.2. LPA observed water sources are inaccessible to children.
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confirming correction by POC date 04/01/2023.




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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:Valarie Cook
LICENSING EVALUATOR NAME:Dayna Chambers
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023


LIC809 (FAS) - (06/04)
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