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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191502175
Report Date: 05/15/2023
Date Signed: 05/15/2023 05:07:02 PM

Document Has Been Signed on 05/15/2023 05:07 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:PLAY FACTORYFACILITY NUMBER:
191502175
ADMINISTRATOR:LANA SHIFFLETFACILITY TYPE:
850
ADDRESS:9723 GARIBALDI AVE.TELEPHONE:
(626) 285-9223
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 65DATE:
05/15/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Director, Lana ShiffletTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with Director Lana Shifflet who guided LPA on a tour of the facility. Census was taken.

During the inspection 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 representative 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.

Facility provided a copy of the facility sketch, LIC 9276, and LIC 9275 to LPA Garcia during this inspection.

On 09/28/2022, 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 09/10/2022. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:
Report continues on next page 1 of 2.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PLAY FACTORY
FACILITY NUMBER: 191502175
VISIT DATE: 05/15/2023
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  • D-"Drinking Fountain_Outdoor 2 of 5". A sink faucet located outside the play area of the facility tested with a result of (6.80 UG/L) – Per Director, this sink faucet is used for hand washing only. During the inspection LPA Garcia was able to verify that the sink faucet was not being use for consumption or food preparation. The proof was verified in person during this inspection and pictures were taken of the sink.

Since the sink faucet is not being used for consumption or food preparation no deficiencies were cited during this inspection.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with facility representative Lana Shifflet. Appeal rights discussed and explained.

Report ends here page 2 of 2.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023
LIC809 (FAS) - (06/04)
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