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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370801650
Report Date: 05/22/2023
Date Signed: 05/22/2023 11:27:26 AM

Document Has Been Signed on 05/22/2023 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MONTESSORI SCHOOL OF SAN DIEGOFACILITY NUMBER:
370801650
ADMINISTRATOR:WINCEK, KARENFACILITY TYPE:
850
ADDRESS:1323 WEST SPRUCE STREETTELEPHONE:
(619) 295-7591
CITY:SAN DIEGOSTATE: CAZIP CODE:
92103
CAPACITY: 72TOTAL ENROLLED CHILDREN: 60CENSUS: 51DATE:
05/22/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Owner, Jim Turner TIME COMPLETED:
11:45 AM
NARRATIVE
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On 5/22/2023, at 9:10am, Licensing Program Analyst (LPA), Vicky Williamson conducted an unannounced case management inspection for the Action Level Exceedance (ALE) of lead detected in facility water fixtures. LPA met with Owner, Jim Turner. The purpose of the inspection was explained, and facility was toured. Present in the facility were 51 preschool children with 6 staff members.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with the owner 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.

On 5/12/2023, the Department obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276) and Facility Sketch (LIC999).

On 5/5/2023, the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 4/15/2023. The outlets/fixtures reported with 5.5 ppb or greater lead exceedance levels were as follows:
C - Sink Faucet - Rm 1 (L)
D - Sink Faucet - Rm 1 (R)
E - Sink Faucet - Rm 2 (R)
K - Drinking Fountain - Hall (R)
L - Sink Faucet - Hall (Mid R)
M - Sink Faucet - Hall (Far R)
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONTESSORI SCHOOL OF SAN DIEGO
FACILITY NUMBER: 370801650
VISIT DATE: 05/22/2023
NARRATIVE
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The five (5) sink faucets are designated as "C, D, E, L, M" on the facility sketch and are located in the following classrooms: Classroom 1 ("C" & "D"), Classroom 2 ("E"), Classroom Room 4 ("L" & "M"). The drinking fountain has been replaced and is designated on the facility sketch as "K" and located in classroom 4. Owner stated that the sink faucets will be will replaced by 6/5/2023. Owner stated and LPA observed that the five (5) sink faucets are used for handwashing only and drinking fountain has been made off limits. Owner stated that the five (5) sink faucets and drinking fountain will be retested no later than 6/12/2023 to have no lead concentration above the CDSS action level of 5 parts per billion (ppb).

Owner stated that the five (5) sink faucets have not been used for drinking water or food preparation and only used for handwashing. Owner stated that the children bring their own water bottles and the facility provides filtered water to refill their bottles. LPA observed filter water available for the children.

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.



LPA informed Owner that this report dated 05/22/2023 documents one (1) Type B citation on the attached 809-D.

LPA advised Owner that parents must be notified of the lead exceedances. Licensee shall post testing results, in a location consistent with the requirements of subsection (b) of section 1596.8595 of the Health & Safety Code, for parents and families to view at the facility within 24 hours of receiving the results from the Department.

Exit interview conducted and report was reviewed with Owner, Jim Turner . A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
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Document Has Been Signed on 05/22/2023 11:27 AM - It Cannot Be Edited


Created By: Vicky Williamson On 05/18/2023 at 03:36 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI SCHOOL OF SAN DIEGO
FACILITY NUMBER: 370801650

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/22/2023
Section Cited

101700.3(b)(2)

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101700.3 California Lead Action Level at Child Care Centers. (b)(2) 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 and safety of children in care. This requirement is not met as evidenced by:
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Owner stated drinking fountain has been replace, with the exception of 5 sink faucets. The 5 sink faucets will be replaced on 6/5/23. Owner stated that the 5 faucets will be retest on 6/12/23. LPA observed that the 5 sink faucets are used for handwashing only and drinking fountain has been made off limits
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On 4/15/23, Licensee failed to maintained a lead value at or below the Action Level for water lead testing resulting with values of 5.5 ppb or greater for C, D, E, K, L, M outlets. Water testing results identified with Action Level Exceedance as defined in WD section 101700.3 are not deemed safe to drink. This poses a potential and health and safety risk to persons in care.
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by a cover and a "do not use" sign.
Owner stated that the children are provided filtered water to refill their water bottles. Owner stated that the test results for the replacement faucets will be submitted to the SDRO by 6/22/23.

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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:Tulam Vu
LICENSING EVALUATOR NAME:Vicky Williamson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2023


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