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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370279
Report Date: 09/16/2022
Date Signed: 09/16/2022 03:57:56 PM

Document Has Been Signed on 09/16/2022 03:57 PM - 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:TUTOR TIME CHILD CARE/LEARNING CENTERFACILITY NUMBER:
304370279
ADMINISTRATOR:ARRIETA, PERLAFACILITY TYPE:
850
ADDRESS:2709 N BRISTOL STREET, STE. E1TELEPHONE:
(714) 550-7120
CITY:SANTA ANASTATE: CAZIP CODE:
92706
CAPACITY: 106TOTAL ENROLLED CHILDREN: 106CENSUS: 37DATE:
09/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Monique Gonzales, Assistant DirectorTIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Romy Castanon conducted an unannounced Case Management visit. LPA met with Assistant Director, Monique Gonzales to discuss the Lead Sampling Testing conducted on 08/25/22. Assistant Director was advised on 09/14/22 that the Lead Sample Report was to be posted. During visit, LPA observed facility staff post the Lead Sample Report.

Assistant Director stated outlet A (6.860 ppb) with high levels of lead is inoperable. Outlet A is located in the restroom of the Tutor Time Village room. The restroom has not been used since 2020 during distance learning and is not currently being used by children enrolled in the facility. Facility staff utilize tables and chairs in the room to take their breaks. LPA observed outlet A that tested with high levels of Lead inoperable via large black trash bag and duct tape wrapped all around. Staff have two designated restrooms in the facility.

Assistant Director stated faucets were replaced, three week flushing begins 9/19/22, will retest and provide copies of the new test results to licensing office.

Based on LPAs record reviews the following violation was observed and is being cited in accordance with
California Code of Regulations Title 22, Division 12, Chapter 1, Subchapter 5 Section 101700.3(b)(1) California Lead Action Level at Child Cares on the attached LIC 809D.

Exit interview was conducted and report was reviewed with the facility representative Monique Gonzales. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were explained. Assistant Director was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2022
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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Document Has Been Signed on 09/16/2022 03:57 PM - It Cannot Be Edited


Created By: Romelia M Castanon On 09/16/2022 at 03:27 PM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TUTOR TIME CHILD CARE/LEARNING CENTER
FACILITY NUMBER: 304370279

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
09/16/2022
Section Cited

101700.3(b)(1)

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(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.
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Asst. Director stated faucets were replaced. Facility three week flushling begins 9/19/22, will retest and provide copies of the new test results to licensing office. Outlet C is inoperable via large black trash bag and duct tape wrapped all around.

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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:Rina Lopez
LICENSING EVALUATOR NAME:Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:
DATE: 09/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/16/2022


LIC809 (FAS) - (06/04)
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