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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412417
Report Date: 07/31/2024
Date Signed: 07/31/2024 12:24:48 PM


Document Has Been Signed on 07/31/2024 12:24 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:KYCC CHILDREN'S CENTERFACILITY NUMBER:
197412417
ADMINISTRATOR:MYUNG JIN RHEEFACILITY TYPE:
850
ADDRESS:1140 CRENSHAW BLVD.TELEPHONE:
(323) 297-0038
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY:72CENSUS: 30DATE:
07/31/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Claudia Garcia, DirectorTIME COMPLETED:
12:30 PM
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On 07/31/2024 at 09:30 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced Case Management -Lead Testing/Exceedance Inspection. LPA identified self and met with Facility Representative (FR) Claudia Garcia, Director, LPA identified reason for the inspection.

Facility Representative (FR) Claudia Garcia, Director, allowed entry into the facility and provided LPA a guided tour of inside and outside of the facility. LPA observed 30 children with 7 staff upon arrival. The facility is currently licensed for a capacity of 72, per FR they currently have 42 enrolled.

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.

On 05/20/2024 LPA contacted the facility and spoke to the Director informing them that the required lead testing conducted at the facility has been identified to have an Action Lead Exceedance (ALE) greater than 5.5 ppb in one of their water outlets. The purpose of the inspection is to ensure that the water outlets with a lead exceedance are not in use and that the facility has potable water for children in care.

LPA was provided with copies of the LIC 9275 External Water Sample Self-Certification Form, the LIC 9276 Child Care Center Sampling Checklist Form, and an updated copy of the LIC 999 Facility Sketch noting all water sources at the facility. LPA was also provided with a copy of the results of the lead water sample testing conducted by CA Rural Water Association.

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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KYCC CHILDREN'S CENTER
FACILITY NUMBER: 197412417
VISIT DATE: 07/31/2024
NARRATIVE
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Testing was conducted on 07/29/2023 and results were received on 05/12/2024. Per the water sample results, the facility had one water outlet with a lead exceedance. The following water outlets yielded the following results:
1. Sample F / Exterior Lower Drinking Fountain / 6.0 ppb.

During the inspection LPA observed an installed filtered water dispenser at the facility as a potable source of water for children in care. The installed filtered water dispenser is located in the kitchen (photo taken). Teachers use pitchers (photo taken) that also have water filters to fill up children's water bottles brought from home.

LPA took pictures during the inspection and observed that the water outlet F was covered, taped, and labeled “Out of Order”. A - Kitchen, B -Aspen Classroom, C- Maple Classroom, D- Willow Classroom, and E -Exterior Lower water outlets are water fountains that did not test above the 5.5 ppb lead exceedance.

Per Director, water outlet with lead exceedance was an exterior drinking fountain that were not used by children in care. Faucets were not used for drinking or food preparations. Prior to the lead testing the facility was already using individual water bottles that were filled from the installed filtered water source water

On 06/02/2023, licensee failed to maintain a lead value at or below the Action Level for water lead testing resulting with values of 5.5 ppb or greater for outlet F. Water testing results identified with Action Level Exceedance as defined in WD section 101700.3. are not deemed safe to drink.

Although Director sealed off faucets with plastic bags, labeled out of order and has A - Kitchen, B -Aspen Classroom, C- Maple Classroom, D- Willow Classroom, and E -Exterior Lower water to correct the issue, an Action Level Exceedance was still recorded and noted by a certified drinking water sampler indicating that there is lead in the water at the facility. Therefore, the following deficiency is being cited in accordance with California Code of Regulations Title 22.



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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KYCC CHILDREN'S CENTER
FACILITY NUMBER: 197412417
VISIT DATE: 07/31/2024
NARRATIVE
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Director has posted lead testing results, in a location (facility lobby) 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. Facility will notify all parents or guardians of children in care of lead exceedance results and what has been done to date and remediation plan for water outlets F.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited on the attached deficiencies page (LIC 809D).

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

Exit interview conducted, appeal rights and report was reviewed with the facility representative, Claudia Garcia, Director.




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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/31/2024 12:24 PM - 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: KYCC CHILDREN'S CENTER
FACILITY NUMBER: 197412417

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2024
Section Cited
CCR
101704

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101704 Lead Action Exceedance Reponse Requirements
If a drinking water outlet test results in an ALE, the use of that outlet ... shall immediately...is replaced and retested ...and returns a result at or below the Action Level. This requirement was not met as evidence by:
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Director stated a vendor will be hired to access the water outliet F -Exterior Lower Drinking Fountain to assess repairs needed or to remove the water outlet source by the plan of correction date 08/30/2024. Director stated they will provide LPA with copies of invoice and pictures.
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Based on record review, the licensee did not ensure water sources at facility meet lead requirements. Lead test results showed that one water sources, outlet F has an action level exceedance. LPA observed water sources are
inaccessible to children.
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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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2024
LIC809 (FAS) - (06/04)
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