304371418-9-13-2022-06-CC-DTHN-CJ8MN2-20220913094448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371418
Report Date: 09/13/2022
Date Signed: 09/13/2022 09:45:26 AM

Document Has Been Signed on 09/13/2022 09:45 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	LAGUNA NIGUEL MONTESSORI CENTER		FACILITY NUMBER:	304371418
ADMINISTRATOR:	MCLANE, DEBBIE		FACILITY TYPE:	850
ADDRESS:	28083 MOULTON PARKWAY # B		TELEPHONE:	(949) 643-1200
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	174	CENSUS:	DATE:	09/13/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Athana Howard		TIME COMPLETED:	10:00 AM

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Licensing Program Analyst (LPA), Dean Thompson conducted an unannounced Case Management Inspection, met with Assistant Director Athana Howard to discuss the Lead Sampling testing conducted 08/24/22. Director was advised on 09/08/22 the Lead Sample Report was to be posted; LPA confirmed the Director posted the Sample Report.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test.

Community Care Licensing was notified that lead water testing conducted at the facility on 08/24/2022 failed allowable limit for lead. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedance (ALE).

Instructions for required lead testing are outlined in PIN 21-21-CCP. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations.

LPA observed Site ID D is located inside room classroom #4. LPA observed the drinking faucet portion of the sink has been removed. Assistant Director stated the sink is being used for hand washing only. Filtered water pitchers are being used for drinking water inside classroom #4 where site ID D is located

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SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LAGUNA NIGUEL MONTESSORI CENTER	FACILITY NUMBER: 304371418
	VISIT DATE: 09/13/2022

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Based on LPA record reviews, the following violation was observed and is being cited in accordance with California Code of Regulations Title 22, Division 12, Chapter 3, Section 101700.3 California Lead Action Level at Child Care Centers is being cited on the attached LIC 809D.

Exit interview conducted and report was reviewed with Assistant Director Athana Howard. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) 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.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/13/2022 09:45 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LAGUNA NIGUEL MONTESSORI CENTER	FACILITY NUMBER: 304371418
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/13/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/13/2022 Section Cited	1 2 3 4 5 6 7	101700.3 California Lead Action Level at Child Care Centers (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.
	8 9 10 11 12 13 14	Based on lab report analysis water from Site ID D faucet (7.940 parts per billion). The faucet samples taken on 08/24/2022 indicate levels of lead in exceedance.	8 9 10 11 12 13 14	.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

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