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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417361
Report Date: 05/15/2024
Date Signed: 05/15/2024 04:25:30 PM

Document Has Been Signed on 05/15/2024 04:25 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:JULIE KORENSTEIN ELEMENTARY CSPP - RM. 2FACILITY NUMBER:
197417361
ADMINISTRATOR/
DIRECTOR:		OLORTEGUI, BRENDAFACILITY TYPE:
850
ADDRESS:7650 BEN AVENUETELEPHONE:
(818) 255-4141
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
05/15/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Oliver Ramirez, PrincipalTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced case management inspection on 05/15/2024 for the purpose of addressing an Action Lead Exceedance (ALE) at the facility. LPA arrived to the facility at 2:25PM and met with Oliver Ramirez, Principal, who instructed Fatima Melendez-Nateras, Teacher, to guide analyst on a tour of the facility. There were 2 staff and no children in care during the inspection.

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 11/29/2022. The sample test was for the water fountain located inside Room 2, identified as letter “A”. Outlet "A" tested at 65.3 ppb which exceeds allowable limits for lead. Test samples testing over 5.5 ppb and above is considered an exceedance.

Principal was advised to posted lead testing results, in a location 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 “A”.

During today’s visit LPA took pictures of the water outlets “A”. LPA received copies of Facility Sketch (LIC 999) in which the water outlet "A" is noted, water testing results dates 12/06/2022 and a Statement of Deficiencies/Plan of Correction. ---Page 1 of 2
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: JULIE KORENSTEIN ELEMENTARY CSPP - RM. 2
FACILITY NUMBER: 197417361
VISIT DATE: 05/15/2024
NARRATIVE
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Documents pending are External Water Sampler Self-Certification Form (LIC 9275); Child Care Center Sampling Checklist Form (LIC 9276); a copy of water retesting results summary for Outlets "A", and a plan on how often the outlet filter will be serviced.

Based on information reported to the Department, it has been determined that JULIE KORENSTEIN ELEMENTARY CSPP - RM. 2 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 Oliver Ramirez, Principal .
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/15/2024 04:25 PM - It Cannot Be Edited


Created By: Lilia Hernandez On 05/15/2024 at 03:49 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: JULIE KORENSTEIN ELEMENTARY CSPP - RM. 2
FACILITY NUMBER: 197417361

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/29/2024
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, Documents pending are External Water Sampler Self-Certification Form (LIC 9275); Child Care Center Sampling Checklist Form (LIC 9276; a copy of water retesting results summary for Outlets "A", 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 information reported to the Department, the facility did not comply with the section cited above in the water outlet located in Room 2, identified as Outlet "A”, tested at 65.3 ppb on 11/29/2022 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 Ramos
LICENSING EVALUATOR NAME:Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024


LIC809 (FAS) - (06/04)
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