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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408649
Report Date: 03/14/2023
Date Signed: 03/14/2023 01:55:43 PM

Document Has Been Signed on 03/14/2023 01:55 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:LOS ANGELES SOUTHWEST COLLEGE CDCFACILITY NUMBER:
197408649
ADMINISTRATOR:MONICA MORENOFACILITY TYPE:
830
ADDRESS:1600 W. IMPERIAL HIGHWAYTELEPHONE:
(323) 241-5003
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY: 44TOTAL ENROLLED CHILDREN: 11CENSUS: DATE:
03/14/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director Marcella McKnight TIME COMPLETED:
02:00 PM
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On 3/14/2023 Licensing Program Analyst (LPA) Dalicia Adkins conducted an unannounced case management- lead testing/exceedance visit. LPA was greeted by director director Marcella Knight and guided on a tour of the facility. There were 11 infants and four teachers present.

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 samples results of 19 UG/L, 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.

During today’s visit LPA Adkins observed water facet/outlets identified on facility sketch. LPA Adkins confirmed with director that outlet T identified as exceedance of lead and shall remain inoperable. Per director the facility has ceased using the outlet and was made inaccessible. LPA observed faucet/outlet T located in small room in the back, this room is not used to care for children and is currently used for storage. LPA observed faucet removed with a plastic bag with signage out of service do not use. LPA observed faucet T capped and decommissioned.

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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LOS ANGELES SOUTHWEST COLLEGE CDC
FACILITY NUMBER: 197408649
VISIT DATE: 03/14/2023
NARRATIVE
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During today’s visit LPA Adkins collected completed copies of External Water Sampler Self-Certification form of LIC 9275, Child Care Center Sampling Checklist form LIC 9276, Facility Sketch LIC 9099 (water faucets/outlets identified) and copy of water testing results summary. LPA Adkins took pictures of faucets/ outlets. Director shared with LPA that staff and parents had recently taken a workshop for lead prevention. Director provided LPA with a copy signed roster of attendees of workshop; protect your child from lead poisoning, dated February 24, 2023.

Per director facility provides water for children and water bottles are re-filled with filtered water. Meals are prepared at the center, faucet O is not used for food preparation. Facility provides snacks for children.

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

Based on observation, interviews and sampling records it has been determined that there was a violation of Licensing Regulation Title Division Written Directives 101700.3 California Lead Action Level at Child Care Centers (b) Testing results with fractional ppb reading of 5.5 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. Lead water testing samples taken on 12/22/22 revealed that levels of lead were beyond allowable amount deemed by the State of California. LPA confirmed with director that faucet

T samples results lead exceedance was level 19 ug/L. This facility is being cited (1) deficiency during today’s visit 3/14/2023 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 , deficiency cleared.

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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LOS ANGELES SOUTHWEST COLLEGE CDC
FACILITY NUMBER: 197408649
VISIT DATE: 03/14/2023
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Letter sent to parents on February 23, 2023 notifying parents of lead results and plan of correction. Facility has permanently cease use of the outlet and is decommissioned.

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. Pin 21-21 CCP discussed with director.

Exit interview conducted and appeal right explained. This report reviewed with licensee and copy provided.

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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/14/2023 01:55 PM - It Cannot Be Edited


Created By: Dalicia Adkins On 03/14/2023 at 12:17 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: LOS ANGELES SOUTHWEST COLLEGE CDC
FACILITY NUMBER: 197408649

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2023
Section Cited

03/14/2023

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101700.3(b)(1) California Lead Action at Child Care Centers (b)Testing results with fractional ppb readings....(1) A result of 5.5ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as by: evidence by:
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Per director the facility has ceased using the outlet and was made inaccessible. LPA observed outlet T taped and covered with a plastic bag, signage out of service do not use, outlet is capped/decommissioned. Water Sampler Self-Certification form of LIC 9275, Child Care Center Sampling Checklist form LIC 9276, Facility Sketch LIC 9099 (water faucets/outlets identified) completed. Faucet T replaced and is following next appropriate steps as outlined in written directives.
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Faucet T sample results 19 ug/L. Action Level Exceedance results revealed that levels of lead were beyond allowable amount deemed by the State of California, if not corrected this poses a potential Health and Safety or Personal Rights 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:Karren Starks
LICENSING EVALUATOR NAME:Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2023


LIC809 (FAS) - (06/04)
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