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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015375
Report Date: 04/26/2024
Date Signed: 04/26/2024 09:36:37 AM

Document Has Been Signed on 04/26/2024 09:36 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:OPTIONS SURROUND CARE - JORDANFACILITY NUMBER:
198015375
ADMINISTRATOR/
DIRECTOR:		CARINA CUEVASFACILITY TYPE:
840
ADDRESS:10654 JORDAN RD.TELEPHONE:
(562) 947-6461
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY: 40TOTAL ENROLLED CHILDREN: 17CENSUS: 0DATE:
04/26/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Site Director/Teacher Sonia Sandoval TIME VISIT/
INSPECTION COMPLETED:
10:00 AM
NARRATIVE
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On 04/26/2024, at 9:00 AM Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection for the purpose of delivering the revised report for a Required - 3 years inspection conducted on 02/23/2024 (Original signatures for revised report on file) and for an Action Level Exceedance (ALE) detected in a water fixture used by the facility. LPA met with facility Site Director/Teacher Sonia Sandoval during the visit. There were 0 children and 2 teachers/staff in the classroom. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility.

Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with Site Director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Facility provided lead test report, facility sketch and required forms LIC 9276, LIC 999 and LIC 9275 to LPA on 02/22/2024.

The Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 02/08/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

ยท Building B, Outside K1, North, Drinking Fountain A (5.75 UG/L)

LPA received a signed Declaration (LIC855) from facility indicating fountains with lead exceedance will not be used and water is delivered. LPA also observed delivered water is present in the classroom.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: OPTIONS SURROUND CARE - JORDAN
FACILITY NUMBER: 198015375
VISIT DATE: 04/26/2024
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Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit
https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

See LIC809D for Type B deficiency cited.

Exit interview conducted and a copy of this report and appeal rights was provided to the Site Director.

A notice of site visit was also provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/26/2024 09:36 AM - It Cannot Be Edited


Created By: Kruz Long On 04/26/2024 at 09:27 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OPTIONS SURROUND CARE - JORDAN
FACILITY NUMBER: 198015375

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/29/2024
Section Cited
CCR
101700.3(b)(1)

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California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater..., 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 is not met as evidenced by: Based on record
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LPA received a signed Declaration (LIC855) from facility indicating fountains with lead exceedance will not be used and water is delivered. LPA also observed delivered water is present in the classroom. POC cleared during site visit.
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review and observations, the licensee did not comply with the directive above, as Building B, Outside K1, North, Drinking Fountain A (5.75 UG/L) tested with an Action Level Exceedance (ALE). This poses an immediate Health and Safety risk to children 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:Ana Chico
LICENSING EVALUATOR NAME:Kruz Long
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2024


LIC809 (FAS) - (06/04)
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