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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843043
Report Date: 03/10/2023
Date Signed: 03/10/2023 11:27:38 AM

Document Has Been Signed on 03/10/2023 11:27 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHINO MONTESSORI SCHOOLFACILITY NUMBER:
364843043
ADMINISTRATOR:IBEL BADIOLAFACILITY TYPE:
850
ADDRESS:6010 RIVERSIDE DRIVETELEPHONE:
(909) 465-6008
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY: 125TOTAL ENROLLED CHILDREN: 99CENSUS: 57DATE:
03/10/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maggie Perez, Assistant Director
Ismat Arastu, Executive Director		TIME COMPLETED:
11:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Kay Turner arrived at the facility to conduct a case management visit regarding the lead testing. LPA met with the Executive Director, Ismat Arastu, and explained the purpose for today's visit. LPA toured the center and a census was taken.

On 02/04/2023, lead testing was completed of the water sources at the facility. The sinks located in the kitchen were tested and found to be at the exceedance level of 5.5. The kitchen sinks were labeled D & B; sink D tested at 23 UG/L and sink B tested at 16 UG/L. The kitchen has been closed due to remodeling, but when in use, the sinks are not used for drinking water. The sinks are used to wash the serving utensils for food provided to the children while at the facility. The children bring their own water bottles from home and the facility refills with store bought water. In addition, the facility has a filtrated water source located in the lobby also used to refill the children's water bottles. The facility's plan of correction is to install a filtration system under the sink. Upon completion, the sinks will be retested. The aforementioned resulted in a deficiency, as the documented lead levels exceeded 5.5 ppb and is above the level of exceedance per the Lead Testing Written Directives. Please see 809D for deficiency.

Exit interview conducted and report was reviewed with the Executive Director/Owner, Ismat Arastu.

A copy of this report was provided to the Executive Director/Owner, Ismat Arastu, and a Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2023
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 03/10/2023 11:27 AM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Karrene Turner On 03/10/2023 at 11:00 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHINO MONTESSORI SCHOOL
FACILITY NUMBER: 364843043

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
04/10/2023
Section Cited

101700.3

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Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health & safety of children in care.
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The plan of correction is install a filtration system under the sink and complete a retest. Upon completion of the retest, the results will be submitted to the LPA.
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Per the sample reported completed on 02/04/2023, the sinks, labeled B and D, located in the kitchen of the facility lead test results were 16 UG/L & 23 UG/L, respectively, above the level of exceedance.
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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:Aaron Ross
LICENSING EVALUATOR NAME:Karrene Turner
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2023


LIC809 (FAS) - (06/04)
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