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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020791
Report Date: 02/27/2024
Date Signed: 02/27/2024 10:54:30 AM

Document Has Been Signed on 02/27/2024 10:54 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:JUBILEE CHRISTIAN SCHOOLFACILITY NUMBER:
198020791
ADMINISTRATOR:HEATHER WARMANFACILITY TYPE:
850
ADDRESS:763 N. SUNSET AVETELEPHONE:
(626) 732-1500
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY: 154TOTAL ENROLLED CHILDREN: 154CENSUS: 59DATE:
02/27/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Sandra Ramirez-Office Operations TIME COMPLETED:
11:05 AM
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On February 27, 2024 Licensing Program Analysts (LPA) Cynthia Reyes conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with Sandra Ramirez, Office Operations during todays visit. Also present in the facility were 59 day care children and 8 teachers/staff. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility. Director Heather arrived shortly after.

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 facility 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. A copy of the lead results from the SWRCB was provided and posted on the parent board.

Facility provided a copy of the facility sketch and required forms LIC 9276, LIC999, LIC9275 and other forms attached to the water sampling that includes a receipt for the new sink to LPA on this date.

(SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 11/21/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

WS-1 – Sink with Faucet In Kitchen "A" (26.3 UG/L) – Sink with Faucet was replaced with a new one on 12/17/2022.

Sandra stated the faucet was used prior to the testing to fill containers of water for children in the class rooms. The new faucet was flushed for 3 months plus beginning on 12/17/2022 and was cleared of any lead exceedances.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: JUBILEE CHRISTIAN SCHOOL
FACILITY NUMBER: 198020791
VISIT DATE: 02/27/2024
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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

A Type B deficiency is being cited under California Code of Regulations Title 22, 101700(b)(1), see LIC809D.

Exit interview conducted and report was reviewed with the facility representative, Sandra Ramirez, Office Operations. Appeal rights were provided to facility on this date. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/27/2024 10:54 AM - It Cannot Be Edited


Created By: Cynthia Reyes On 02/27/2024 at 10:31 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: JUBILEE CHRISTIAN SCHOOL
FACILITY NUMBER: 198020791

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2024
Section Cited
CCR
101700(b)(1)

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101700.3(b)(1) California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater... (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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LPA observed that the water outlet “A”, Kitchen faucet/sink was observed to be removed and replaced with a new filtered faucet/sink and a copy of the receipt and 3 month flushing of the new sink was provided.
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This requirement is not met as evidenced by: Based on testing results provided by the facility with an Action Level Exceedance (ALE) of 26.3 ppb which poses/posed a potential health, safety, or personal rights risk to persons/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:Christina Gabelman
LICENSING EVALUATOR NAME:Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2024


LIC809 (FAS) - (06/04)
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