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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017276
Report Date: 11/30/2022
Date Signed: 11/30/2022 11:29:28 AM


Document Has Been Signed on 11/30/2022 11:29 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:WISDOM ELEMENTARY SCHOOL CSPPFACILITY NUMBER:
198017276
ADMINISTRATOR:YVONNE VASQUEZFACILITY TYPE:
850
ADDRESS:1125 E. 74TH STREETTELEPHONE:
(323) 586-5760
CITY:LOS ANGELESSTATE: CAZIP CODE:
90001
CAPACITY:27CENSUS: 13DATE:
11/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Yvonne Vasquez, PrincipalTIME COMPLETED:
11:30 AM
NARRATIVE
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On November 30, 2022, at 9:15 a.m., Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced case management inspection and met with Principal Yvonne Vasquez. LPA disclosed the purpose of the inspection and was granted entry into the facility by Principal.

There were 13 children and three staff present during the inspection.

The purpose of today's inspection was to discuss the water lead test results. Results show that two water sources have action level exceedance (ALE) of lead. The drinking fountain located outdoors and a drinking fountain/hand washing faucet indoors had a lead exceedance of 81.6 and 9.3.

At 9:30 a.m. LPA observed and took pictures of the water sources with ALE. Water sources were observed to be inaccessible to children. The water to the drinking fountains indoors and outdoors have been turned off. A bag has been placed over the hand washing faucet. Per Staff, families are asked to bring water bottles from home. LPA observed children's water bottles. LPA did not observe any other source of water readily available for children to fill empty water bottles or a way to provide children with water if they forget to bring a water bottle. LAUSD Lead exceedance team has begun to correct the ALE and is in the process of installing filters to the affected water sourced. LAUSD facility maintenance has not given a date to begin work. A deficiency was cited to ensure that the water sources with the exceedance will not be used as a drinking source or food preparation source for the children. A deficiency will also be cited to ensure non-contaminated water is made readily available both indoors and outdoors.

Per Principal, all meals are prepackaged and delivered daily by Los Angeles Unified School District (LAUSD). Food is not cook or prepared at the facility.

The deficiency listed on the following page was observed by the LPA and is being cited in accordance with ----------------------PAGE 1
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2022
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 11/30/2022 11:29 AM - 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: WISDOM ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 198017276

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2022
Section Cited

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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.
This requirement was not met as evidence by:
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Based on record review the licensee did not ensure water sources at facility meet lead requirements. Lead test results showed that two drinking water sources have an action level exceedance. LPA observed water sources are inaccessible to children.
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Type B
12/02/2022
Section Cited

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101639.2(c) Drinking Water
(c) Drinking water from a non contaminating fixture or container shall be readily available to children both indoors and in the outdoor activity area.
This requirement was not met as evidence by:
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Based on record review the licensee did not ensure water was made readily available to fill water bottles provided by parents both indoors and outdoors.
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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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2022
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WISDOM ELEMENTARY SCHOOL CSPP
FACILITY NUMBER: 198017276
VISIT DATE: 11/30/2022
NARRATIVE
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California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared 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 and Plans of Corrections were reviewed and developed with Principal. A copy of this report and appeal rights were discussed and left with Principal, Yvonne Vasquez, whose signature on this form confirm receipt of these documents.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3