<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011608
Report Date: 03/02/2023
Date Signed: 03/02/2023 10:02:01 AM

Document Has Been Signed on 03/02/2023 10:02 AM - 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:OAKWOOD ACADEMYFACILITY NUMBER:
198011608
ADMINISTRATOR:CATHERINE MATSUBARAFACILITY TYPE:
850
ADDRESS:3850 LONG BEACH BOULEVARDTELEPHONE:
(562) 426-6264
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 114TOTAL ENROLLED CHILDREN: 114CENSUS: 76DATE:
03/02/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Ana Sanchez, DirectorTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On March 2, 2023, at 8:45AM., Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced case management inspection and met with Ana Sanchez, Director. The Preschool program consists of 7 open classrooms. Facility operation hours are Monday to Friday from 6:00 AM to 6:00 PM. There were 76 children and 11 staff present during the inspection.
The purpose of today's inspection was to discuss the water lead test results. Results show that 1 water sources have action level exceedance (ALE) of lead: Building B-Tree Frogs: Drinking Fountain used for drinking water have a lead exceedance of 7.28 points per billion (ppb).
Per Director, this fountain has not been used for over 5 years. LPA took photo of sink where the removed drinking fountain was located. Lead testing was completed on 12/16/2022. The drinking fountain was removed from the premises on 12/16/2022 and not replaced. There are no plans to replace the fountain. LPA observed pitchers of water and cups in each classroom and is readily available to children. The water comes from bottles of filtered water.
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.

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 by 03/15/2023 to protect the children’s health & safety.

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

Exit interview was conducted. A copy of this report and appeal rights were discussed and provided to Director Ana Sanchez, whose signature on this form confirm receipt of these documents.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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 2
Document Has Been Signed on 03/02/2023 10:02 AM - It Cannot Be Edited


Created By: Dayna Chambers On 03/02/2023 at 09:52 AM
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: OAKWOOD ACADEMY
FACILITY NUMBER: 198011608

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/02/2023
Section Cited
CCR
101700.3(b)(1)

1
2
3
4
5
6
7
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.
1
2
3
4
5
6
7
Water sources showing ALE have been removed from the sink on the same day as the lead testing occurred 12/16/2022. There is no plan to reinstall a fountain The exceedance has been corrected since 12/16/2022.

8
9
10
11
12
13
14
This requirement was not met as evidence by:
Based on record review the licensee did not ensure water source at facility meet lead requirements. Lead test results showed that 1 water source had an action level exceedance. LPA observed the fountain in Building B, Tree Frogs room was completely removed from premises.

8
9
10
11
12
13
14

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:Valarie Cook
LICENSING EVALUATOR NAME:Dayna Chambers
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2