197494762-1-19-2023-30-CC-LCLN-CN8TRC-20230119135719

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494762
Report Date: 01/19/2023
Date Signed: 01/19/2023 01:57:44 PM

Document Has Been Signed on 01/19/2023 01:57 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:	TUVIA SCHOOL OF TEMPLE MENORAH		FACILITY NUMBER:	197494762
ADMINISTRATOR:	KATHRYN KANG		FACILITY TYPE:	840
ADDRESS:	1101 CAMINO REAL		TELEPHONE:	(310) 316-8444
CITY:	REDONDO BEACH	STATE: CA	ZIP CODE:	90277
CAPACITY: 75	TOTAL ENROLLED CHILDREN: 75	CENSUS: 11	DATE:	01/19/2023
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	FELICIA FLORES, DIRECTOR		TIME COMPLETED:	02:15 PM

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On 01/19/2023 Licensing Program Analyst (LPA) Lisa Clayton, conducted an unannounced case management - deficiencies visit. LPA was greeted by Director Felicia Flores. LPA Clayton toured the facility and observed 11 children being care for and supervised appropriately by 1 teachers.

LPA Clayton explained the purpose of the visit. The department has received testing results, indicating a water outlet has been identified with an Action Level Exceedance (ALE) in the amount of lead in water being 5.5 ppb, or greater.

Lead water testing samples collected on 11/12/2022 revealed that levels of lead were beyond allowable amount deemed by the State of California. Director Felicia Flores stated the facility will notify all parents via email and post the Lead Testing Results on the parent board no later than close of business tomorrow 01/20/2023.

During today’s inspection, LPA Clayton reviewed the following documents: Child Care Center Sampling Checklist Form (LIC 9276), External Water Sampler Self-Certification Form (LIC 9275) Facility Sketch labeled with locations of all water outlets that were tested.

LPA Clayton observed the water outlet (kitchen sink Faucet K) in question, which is located on the second floor of the school/church. There is another faucet in the kitchen being used to prepare food. LPA Clayton observed the above-mentioned sink has been made inaccessible and has clearly marked signs posted over it. See LIC 812 ALE FAUCET PHOTOS.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

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: TUVIA SCHOOL OF TEMPLE MENORAH	FACILITY NUMBER: 197494762
	VISIT DATE: 01/19/2023

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Due to the Lead water testing samples collected on 11/12/2022 which are exceed the allowable amount deemed by the State of California, per the Written Directives for Lead Testing of Water in Licensed Child Care Center, AB 2370 the following deficiency is cited (See next page 809-D).

For more information, go to the California Childhood Lead Poisoning Prevention Branch's website at www.cdph.ca.gov/programs/clppb Please see Provider Information Notice (PIN) 20-01-CCP for more information about lead toxicity prevention.

An Exit interview was conducted, and appeal right explained. A copy of this report, appeal rights, and Notice of Site Visit provided to Felicia Flores, Director.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/19/2023 01:57 PM - It Cannot Be Edited

Created By: Lisa Clayton On 01/19/2023 at 01:33 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: TUVIA SCHOOL OF TEMPLE MENORAH	FACILITY NUMBER: 197494762
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/19/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/19/2023 Section Cited 101700.3(b)(1)	1 2 3 4 5 6 7	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 evidence by the Action Level Exceedance results revealed	1 2 3 4 5 6 7	As of December 06, 2022 the faucet has been made inaccessible to kitchen staff and Teachers. Per Director Felicia, the Temple Board has made arrangements for the faucet to be repaired and the expected date is 30 days from the date of this report (February 18, 2023.
	8 9 10 11 12 13 14	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.	8 9 10 11 12 13 14	LPA Clayton advised Director Felicia to keep the Department updated on the status of the repairs, if they are not completed by the above -mentioned date, and to provide photos of the completed repairs.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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:

Mary Ruiz

LICENSING EVALUATOR NAME:

Lisa Clayton

LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

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