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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570686
Report Date: 12/07/2022
Date Signed: 12/07/2022 04:37:30 PM

Document Has Been Signed on 12/07/2022 04:37 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:FLANNER HEAD START PRESCHOOLFACILITY NUMBER:
191570686
ADMINISTRATOR:DARLENE MATAFACILITY TYPE:
850
ADDRESS:1314 N. LEBORGNETELEPHONE:
(626) 931-3151
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 96TOTAL ENROLLED CHILDREN: 45CENSUS: 13DATE:
12/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Rosa Ducoing & Lucy BarceloTIME COMPLETED:
04:45 PM
NARRATIVE
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On 12/7/2022 at 1:45 pm. Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted prior to entering the facility. There have been 1 positive case as of December 6, 2022 and LPA switched to an N-95 mask. LPA met with Program Manager, Lucy Barcelo, and approximately around 2:00pm met with Director, Rosa Ducoing who led LPA on a tour of the facility to gather children and staff census. There were 13 children and 6 staff present during the inspection.

The purpose of the visit today, December 7, 2022 was to amend original report dated 11/28/2022, for a Lead Inspection Visit. Due to exceedance of 5.5 parts per billion for 2 water fountains, one located inside the classroom and the other outside in the play yard, a citation was not given the day of the visit. LPA returned today to issue citation due to children having drank from those water fountains prior to Covid in March 2020.

The deficiency listed on the following page were observed by the LPA and is being 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, along with appeal rights given to Director, Rosa Ducoing. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2022
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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Document Has Been Signed on 12/07/2022 04:37 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 12/07/2022 at 03:00 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: FLANNER HEAD START PRESCHOOL
FACILITY NUMBER: 191570686

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/12/2022
Section Cited
CCR
101700.3(b)(1)

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Testing results with fractional ppb readings of 5.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level.
This requirement was not met as evidence by record review.
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Per Program Manager children use Sparkletts Water service located inside each classroom for drinking water using dixie cups and children have constant access. Also, Meals and snacks are brought in by the Bassest Unified School Distict Child Nutrition Services.
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Lead test results showed that fountains in the classroom and outside the playyard had an action level exceedance. LPA observed water faucets to be made inaccessible via plastic cover.
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The facility will provide a written statement on their plan to continue to ensure that the water sources will not be used as a drinking by the POC date of 12/12/2022.

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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:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022


LIC809 (FAS) - (06/04)
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