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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400109
Report Date: 12/01/2022
Date Signed: 12/01/2022 11:36:24 AM

Document Has Been Signed on 12/01/2022 11:36 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:BRIGHT HORIZONS AT UNIVERSITY PARK (USC)FACILITY NUMBER:
198400109
ADMINISTRATOR:AILEEN VALINO-CAMCAMFACILITY TYPE:
850
ADDRESS:2716 SERVERANCE STTELEPHONE:
(310) 692-5164
CITY:LOS ANGELESSTATE: CAZIP CODE:
90089
CAPACITY: 129TOTAL ENROLLED CHILDREN: 69CENSUS: 48DATE:
12/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Aileen Valino-Camcam, Site SupervisorTIME COMPLETED:
12:00 PM
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On 12/01/2022 at 9:10 AM, Licensing Program Analyst (LPA) Katrina Chicote conducted an unannounced case management inspection to the above facility and met with Aileen Valino-Camcam, Site Supervisor. LPA disclosed the purpose of the inspection and was provided a guided tour of the facility both indoors and outdoors. Facility also has an Infant Program with a Toddler Component on site (Facility #198400110).

There were 48 children and 15 staff present during the inspection.

The purpose of today's inspection was to discuss the water lead test results. Results show that one water source has an action level exceedance (ALE) of lead. The drinking fountain located inside 2 year old classroom, RM2s-1, had a lead exceedance of 20. Site Supervisor states that there are currently 13 enrolled in this classroom. The Regional Office did receive a call to the On Duty officer on 10/28/2022 notifying Department of lead exceedance at the facility. On 11/17/2022, LPA received email with LIC 9275 and LIC 9276 attached.

At 9:20 AM, LPA observed and took pictures of the water source with ALE. Water source was observed to already have been removed at time of inspection and blocked by children's cubbies. Site Supervisor stated upon receiving notice of the lead exceedance the water source to the drinking fountain was shut off and a work order was submitted to remove the drinking fountain. Site Supervisor provided photo of drinking fountain shut off and the water fountain was removed on 11/30/2022. Per Site Supervisor, this water fountain has not been used by the facility as the policy is for families to bring personal water bottles from home and refilled in water fill stations that LPA observed in hallways of facility. LPA observed children's water bottles during inspection. Per Site Supervisor, if children forget to bring water bottles they are provided with water cups through out the day.
Report Continues - Page 1 of 2
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BRIGHT HORIZONS AT UNIVERSITY PARK (USC)
FACILITY NUMBER: 198400109
VISIT DATE: 12/01/2022
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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.

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. Proof of corrections letter was provided to facility as drinking water has been removed as of 11/30/2022.

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 Site Supervisor. A copy of this report and appeal rights were discussed and left with Site Supervisor, Aileen Valino-Camcam, whose signature on this form confirm receipt of these documents.
Report Ends - Page 2 of 2
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 12/01/2022 11:36 AM - It Cannot Be Edited


Created By: Katrina Chicote On 12/01/2022 at 10:47 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: BRIGHT HORIZONS AT UNIVERSITY PARK (USC)
FACILITY NUMBER: 198400109

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2022
Section Cited
CCR
101700.3(b)(1)

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(b) Testing results with fractional ppb readings of 0.5 ppb or greater ... 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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Site Supervisor states they shut off water source upon receipt of lead results and work order to remove drinking fountain completely. LPA observed drinking fountain to be removed during inspection clearing deficiency on this date.
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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 one water source has an action level exceedance. LPA observed water source has been removed.
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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 Cochran
LICENSING EVALUATOR NAME:Katrina Chicote
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022


LIC809 (FAS) - (06/04)
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