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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416734
Report Date: 04/04/2024
Date Signed: 04/04/2024 04:15:14 PM


Document Has Been Signed on 04/04/2024 04:15 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:STRATHERN ELEMENTARY SCHOOL CSPPFACILITY NUMBER:
197416734
ADMINISTRATOR:AGUILAR, ANTHONYFACILITY TYPE:
850
ADDRESS:7939 ST. CLAIRE AVENUE-ROOM 6TELEPHONE:
(818) 765-4234
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:24CENSUS: 0DATE:
04/04/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:14 PM
MET WITH:John Dargahi, Principal TIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPAs) Joe Katrdzhyan and Lilia Hernandez conducted an unannounced case management inspection on 04/04/2024 for the purpose of addressing an Action Lead Exceedance (ALE) at the facility. LPAs arrived to the facility at 2:30PM and met with John Dargahi, Principal, who instructed Joyce Miles, Assistant Principal to guide analysts on a tour of the facility. LPA observed no children in care. 2 staff were present upon arrival.

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 of the results of the Lead Water Testing conducted at the facility on 11/16/2022 and results were received on 11/18/2022. The sample test was for the water fountain located inside Room 3, identified on the facility sketch by letter “A”, and water fountain with two outlets outside of Room 3 identified on the facility sketch by letter “B” and "C". outlet "B" tested at 10.00 ppb exceed allowable limit for lead. Test samples testing over 5.5 ppb and above is considered an exceedance.

Licensee was advised to posted lead testing results, in a location (facility lobby) consistent with the requirements of subsection (b) of section 1596.8595 of the Health & Safety Code, for parents and families to view at the facility within 24-hours of receiving the results from the Department. Facility will notify all parents or guardians of children in care of lead exceedance results and what has been done to date and remediation plan for water outlet “B”.

During today’s visit LPA took pictures of the water outlets “A”, "B, and “C”. LPA received copies of Facility Sketch (LIC 999) in which all water outlets are noted, water testing results dates 11/18/2022, and a Statement of Deficiencies/Plan of Correction from Principal.
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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024
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


Document Has Been Signed on 04/04/2024 04:15 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: STRATHERN ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416734

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2024
Section Cited
CCR
101700.3(b)(1)

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(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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Per Principal, updates for corrections to Outlet "B", water retesting results and a plan on how often the outlet filter will be serviced will be submitted to LPA Hernandez via email by POC due date.
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This requirement was not met as evidence by: Based on interview and supportive documents, the facility did not comply with the section cited above in the water outlet located outside Room 3, identified on the facility sketch by letter “B”, tested at 10.0 ppb on 10/16/2022 exceeding allowable limit for lead which poses a potential Health, Safety or Personal Rights risk to persons 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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: STRATHERN ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 197416734
VISIT DATE: 04/04/2024
NARRATIVE
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Documents pending are External Water Sampler Self-Certification Form (LIC 9275); Child Care Center Sampling Checklist Form (LIC 9276); proof of corrections for Outlet "B", a copy of water retesting results summary for Outlet "B" and a plan on how often the outlet filter will be serviced.

Based on interviews and supportive documents it has been determined that STRATHERN ELEMENTARY SCHOOL CSPP violated Child Care Licensing Regulation Division 12, Chapter 1, Subchapter 5 101700.3 (b)(1) California Lead Action Level at Child Care Centers. A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This is a type B violation which poses a potential Health, Safety or Personal Rights risk to persons in care. Refer to LIC 809-D for deficiency page.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with John Dargahi, Principal.

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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3