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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670971
Report Date: 11/30/2023
Date Signed: 11/30/2023 03:22:20 PM

Document Has Been Signed on 11/30/2023 03:22 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ST JOHNS CHILD STUDY CENTERFACILITY NUMBER:
191670971
ADMINISTRATOR:LAURA OSORIOFACILITY TYPE:
850
ADDRESS:1339 20TH STREETTELEPHONE:
(310) 829-8921
CITY:SANTA MONICASTATE: CAZIP CODE:
90404
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 19DATE:
11/30/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:31 PM
MET WITH:Laura BenaventeTIME COMPLETED:
03:40 PM
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On 11/30/2023, Licensing Program Analysts (LPA) Judy Laureano and Ranita Richmond conducted an unannounced case management visit. LPAs Richmond and Laureano were greeted by Director Laura Benavente and granted entry into the facility. Director guided LPAs Richmond and Laureano on a tour of the facility. There were 8 staff members and 19 children, 1 assistant director and facility director present during the visit.

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 10/27/2023 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 11/13/2023 LPA Laureano received notification of lead exceedance via email.

The facility has been identified to have 1 water faucet/outlet with an Action Level Exceedance (ALE) in the amount of lead in water being 5.5pb, or greater. LPAs Laureano and Richmond confirmed with director the following outlet/faucet, “C” in outdoor pathway between classrooms D and E, identified as exceedance of lead and shall remain inoperable. Outlet/faucet is outdoors and children have access to drinking water inside of the classroom and via refillable water bottles.

During the facility inspection LPAs received the following documents from facility, LIC 9275, LIC 9276, Facility Sketch (water faucets/outlets identified). LPA Richmond took pictures of water outlet/faucet in outdoor pathway between classrooms D and E.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ST JOHNS CHILD STUDY CENTER
FACILITY NUMBER: 191670971
VISIT DATE: 11/30/2023
NARRATIVE
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LPAs Richmond and Laureano observed all outlets identified with an Action Level Exceedance to be made inaccessible to the children in care. LPAs Interviewed director and staff to ensure children do not have access to the identified outlet/faucet that has been identified as exceedance of lead. Children have access to water via water bottles in each classroom and while outdoors children bring their own refillable water bottles. LPAs observed water bottles in the facility as well as children’s refillable water bottles.

Based on observation, interviews 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 on 10/27/2023 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 11/30/2023. 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.

LPAs discussed Proof of Correction (POC) with Director. All faucets identified with an Action Lead Exceedance of 5.5 ppb or over have been made inaccessible to the children in care. The outlet will not be accessible for use until facility removal. A notification of letter will be drafted by facility to sent out to parents with notification of cease of water outlets and remediation for planned for water outlets or alternative. Director will send LPAs a copy of the letter via email by 12/14/2023. Facility will work on scheduling for removal of identified outlets when repairs are completed. Director will provide LPAs a picture of correction (removal of outlet) 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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
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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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ST JOHNS CHILD STUDY CENTER
FACILITY NUMBER: 191670971
VISIT DATE: 11/30/2023
NARRATIVE
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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

Director received Notice of Site Visit and copy of this report

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
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Document Has Been Signed on 11/30/2023 03:22 PM - It Cannot Be Edited


Created By: Ranita Richmond On 11/30/2023 at 02:37 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 JOHNS CHILD STUDY CENTER
FACILITY NUMBER: 191670971

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2023
Section Cited
CCR
101700.3(b)(1)

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101700.3(b)(1), A result with values of 5.5 ppb
or greater shall be deemed an ActionLevel
Exceedance

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Facility has made faucet/ outlet, identified
with an Action Lead Exceedance of 5.5 ppb or
over inaccessible for use until a removal has
occurred. Director will email LPA a copy of
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Based on observation,interviews, and review of
lead water testing samples taken on
10/27/2023 revealed that levels of lead were
beyond allowable amount deemed by the State
of California- 1 water outlet/faucet (outdoor pathway between classroom D and E).This poses a potential health and safety risk to children in care.
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parent notification letter via email by 12/14/2023.
Director will send LPA a copy of schedule
removal.

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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:Claudia Escobedo
LICENSING EVALUATOR NAME:Ranita Richmond
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023


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