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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411826
Report Date: 12/07/2022
Date Signed: 12/07/2022 01:17:09 PM

Document Has Been Signed on 12/07/2022 01:17 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:HARMONY ELEMENTARY SCHOOL-ST. PRESCHOOLFACILITY NUMBER:
197411826
ADMINISTRATOR:CONSUELO MONREAL RAMIREZFACILITY TYPE:
850
ADDRESS:899 EAST 42ND PLACE-RM #150TELEPHONE:
(323) 238-0791
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 6DATE:
12/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Consuelo Monreal Ramirez, PrincipalTIME COMPLETED:
01:30 PM
NARRATIVE
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On December 7, 2022, at 12:10 p.m., Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced case management inspection and met with Principal Consuelo Monreal Ramirez. LPA disclosed the purpose of the inspection and was granted entry into the facility by office staff.

There were six children and two staff present during the inspection.

The purpose of today's inspection was to discuss the water lead test results. Results show that two water sources have action level exceedance (ALE) of lead. The drinking and hand washing faucets located inside the classroom and the water fountains outside, between Room #147 and #148 have a lead exceedance of 108 points per billion(ppb) and 14ppb.

At 12:15 p.m. LPA observed and tested the water sources with ALE. Drinking fountain water was observed to be turned off and inaccessible to children. Per classroom staff, water is made readily available to children via water bottles provided by the facility. Children also bring their own water bottles from home. LPA observed water bottles in the classroom and extra water bottles on hand. LPA reminded principal that lead results must be posted where they are accessible to parents. LAUSD Lead exceedance team has begun to correct the ALE by shutting off the water. Filters have been installed and facility is waiting for sources to be retested. LAUSD facility maintenance has not been given a retest date. A deficiency was cited to ensure that the water faucets with the exceedance will not be used as a drinking source or food preparation source for the children.

Per Principal, all meals are prepackaged and delivered daily by Los Angeles Unified School District (LAUSD). Food is not cook or prepared at the facility.

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 to protect the children’s health & safety. -----------------PAGE 1
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2022
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: HARMONY ELEMENTARY SCHOOL-ST. PRESCHOOL
FACILITY NUMBER: 197411826
VISIT DATE: 12/07/2022
NARRATIVE
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A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and Plans of Corrections were reviewed and developed with Principal. A copy of this report and appeal rights were discussed and left with Principal, Consuelo Monreal Ramirez, whose signature on this form confirm receipt of these documents.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/07/2022 01:17 PM - It Cannot Be Edited


Created By: Denise Gibbs On 12/07/2022 at 12:26 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: HARMONY ELEMENTARY SCHOOL-ST. PRESCHOOL
FACILITY NUMBER: 197411826

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2022
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.
This requirement was not met as evidence by:
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Water sources showing ALE have been shut off and filters have been added, children do not have access. Per plant manager, facility is waiting for the water sources to be retested. Retest date is still being determined. Principal or Lead Exceedance team will send LPA an email confirming corrections by POC date 12/16/22.
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Based on record review the licensee did not ensure water sources at facility meet lead requirements. Lead test results showed that two water sources have an action level exceedance. LPA observed water source is inaccessible to children.
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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:Trevino Cochran
LICENSING EVALUATOR NAME:Denise Gibbs
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022


LIC809 (FAS) - (06/04)
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