191290371-8-30-2023-33-CC-NTCG-CV7TMT-20230830145141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290371
Report Date: 08/30/2023
Date Signed: 08/30/2023 02:51:48 PM

Document Has Been Signed on 08/30/2023 02:51 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	JEFFERSON CHILDRENS CENTER		FACILITY NUMBER:	191290371
ADMINISTRATOR:	REE HUDSON		FACILITY TYPE:	850
ADDRESS:	391 NORTH SIERRA BONITA		TELEPHONE:	(626) 796-8845
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY: 70	TOTAL ENROLLED CHILDREN: 70	CENSUS: 39	DATE:	08/30/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	02:17 PM
MET WITH:	Carolina Arizaga - Site Supervisor		TIME COMPLETED:	03:15 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. Upon Arrival at 2:17pm, LPA met with Site Supervisor Carolina Arizaga, who guided LPA on a tour of the facility. There were children present during the time of the inspection.

Census was taken. LPA observed 39 children with 6 staff members.

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

During today's visit, the facility did not have a record of the results of the water testing. Site Supervisor stated that they were not provided anything for any of the Pasadena Unified School District (PUSD) facilities from the Water Testing company. LPA was with Site Supervisor when they reached out to the PUSD office and the Water Testing company. The Sampler was out of the office and they were unable to provide information during the time of the inspection. At this time, LPA discussed with Site Supervisor about the facility water drinking policy and reviewed the sinks that would be available for drinking water and food prep. There was no way of indicating which outlet was the labeled exceedance.

At this time Outlet B is noted as having an exceedance with a testing resutl of 5.87ppb. LPA will return at a later date once documentation has been received for review the specific water outlet

Notice of Site Visit was provided and must remain post for 30 consecutive days. A copy of PIN 21-21-CCP and appeal rights were provided to facility today.

An exit interview conducted with Site Supervisor Carolina Arizaga and a copy of this report was provided.

END OF REPORT

NAME OF LICENSING PROGRAM MANAGER: Claudia Guangorena
NAME OF LICENSING PROGRAM ANALYST: Nolan Tcheng
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 1