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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500522
Report Date: 03/24/2023
Date Signed: 03/24/2023 04:11:12 PM

Document Has Been Signed on 03/24/2023 04:11 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ONEONTA NURSERY SCHOOLFACILITY NUMBER:
191500522
ADMINISTRATOR:KAREN VAHALAFACILITY TYPE:
850
ADDRESS:1515 S. GARFIELDTELEPHONE:
(626) 799-3105
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY: 55TOTAL ENROLLED CHILDREN: 55CENSUS: 0DATE:
03/24/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:24 PM
MET WITH:Director Brittany ShiffermanTIME COMPLETED:
04:30 PM
NARRATIVE
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On 03/24/2023, at 2:24 PM, Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in the water fixture in the facility. LPA met with facility director Brittany Shafferman, during the visit. There were 0-day care children present. A COVID 19 risk assessment was conducted prior to entering the facility.

Analyst 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.

Facility provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPA on 03/08/23. On 02/28/2023, 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 02/11/2023. Faucets and drinking fountains reported with 5.5 ppb or greater lead
exceedance levels were as follows:
A – Sink Faucet in Sunroom Classroom (9.200 UG/L) – Faucet used only for hand washing
C – Sink Faucet in Sunroom Classroom (12.000 UG/L) – Faucet used only for hand washing
D – Sink Faucet in Sunroom Classroom (11.000 UG/L) – Faucet used only for hand washing
G – Sink Faucet in Greenhouse Classroom (7.900 UG/L) – Faucet used only for hand washing
I – Sink Faucet in Crib Classroom (9.900 UG/L) – Faucet used only for hand washing
J – Play yard Water Fountain (5.600 UG/L) – Faucet is currently not in use
K –Treehouse Sink Faucet Classroom (9.300 UG/L) – Faucet used only for hand washing
L – Water Fountain across from Treehouse Classroom (22.000 UG/L) – Faucet is currently not in use

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ONEONTA NURSERY SCHOOL
FACILITY NUMBER: 191500522
VISIT DATE: 03/24/2023
NARRATIVE
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Director stated that the facility was using the faucets occasionally to rinse fruits, rinse dishes, and filling Brita Jugs prior to the discovery of its lead level exceedance but for no other type of meal preparation. The faucet’s use was terminated when the facility was informed by analyst that it was exceeding acceptable levels. Facility has put an "out of order/do not use" sign on the play yard fountain and water fountain across from the Treehouse classroom and made it further inaccessible by attaching and securing a plastic bag around the outlet. The other faucets are currently being used for hand washing only. Per director, the facility provides water via Brita filtered water and Sparkletts Jugs. Ms. Brittany stated that 2 faucets will be removed, 6 faucets will be replaced and obtain a retest of it afterwards.

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

Type B deficiency cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

Exit interview conducted and report was reviewed with the facility representative, Director Brittany Shafferman. A copy of PIN 21-21-CCP and appeal rights were provided to facility today. A notice of site visit was also provided and must remain posted for 30 days.


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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/24/2023 04:11 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 03/24/2023 at 03:41 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ONEONTA NURSERY SCHOOL
FACILITY NUMBER: 191500522

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/23/2023
Section Cited
CCR
101700.3(b)(1)

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101700.3(b)(1) California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater..., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement
is not met as evidenced by:
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Director stated the drinking fountains found to be in lead exceedance, in the play yard and accross from the treehouse class, were last used in 2019 and the sink faucets were last used on 02/27 once the facility received the lead exceedance results. Per director, the sink faucets are currently only used for hand washing with appropriate postings.
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Based on record review, the licensee did not comply with the directive above, as eight outlets (outlet used for drinking water, rinsing dishes and occasionally rinsing fruits) out of thirteen outlets tested with an Action Level Exceedance (ALE). This poses an immediate Health and Safety risk to children in care.
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Director has covered the the drinking fountains..... posted appropriate "do not use" signage immediately around it. The facility provided a written statement on their plan to continue to ensure that the water sources will not be used as a drinking source by the POC date of 06/23/2023.

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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:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2023


LIC809 (FAS) - (06/04)
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