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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191595372
Report Date: 02/13/2024
Date Signed: 02/13/2024 12:53:22 PM

Document Has Been Signed on 02/13/2024 12:53 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:HILLCREST COUNTRY DAY SCHOOLFACILITY NUMBER:
191595372
ADMINISTRATOR:LINDA VANDER WENDEFACILITY TYPE:
840
ADDRESS:2000 WEST ROADTELEPHONE:
(562) 533-2354
CITY:LA HABRA HEIGHTSSTATE: CAZIP CODE:
90631
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 5DATE:
02/13/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Linda Vande WendeTIME COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) A. Silva conducted a Case Management - Lead visit to follow up on the Lead Sampling Testing dated 7/8/2022. Upon arrival, the test results for water outlet(s) B and J were discussed with Director Linda Vande Wende. The results are at a Lead Action Level Exceedance with values of 5.5 ppb or greater. The LPA reminded the director that the instructions for required lead testing are outlined in PIN 21-21.1-CCP WRITTEN DIRECTIVES FOR LEAD TESTING OF WATER.

PIN 21-21.1-CCP Written Directives have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations. Per Written Directives, Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers constructed before January 01, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and every 5 years after the date of the first test, and to notify parents or legal guardians of children enrolled of the requirement to test the drinking water and the results of the test.

The director had the facility tested for lead on 7/8/2022 but a plan of correction was never issued. On 2/13/24, the director did not have evidence of correction of the lead exceedance. The LPA advised the director to post the most current Lead Sample Report (i.e. the test results) which was provided by the LPA. The Lead Sample Report was posted while the LPA was present at the facility.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2024
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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Document Has Been Signed on 02/13/2024 12:53 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 02/13/2024 at 12:26 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HILLCREST COUNTRY DAY SCHOOL
FACILITY NUMBER: 191595372

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2024
Section Cited

101704(a)

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101704 (a) If a drinking water outlet test results in an Action Level Exceedance, the use of that outlet for drinking and food preparation purposes shall immediately cease until it is replaced and retested pursuant to section 101705 and returns a result at or below the Action Level.
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The director cancelled the use of the water source placing a plastic bag over it and a do not use sign near the water source. The director stated the water source will be tested as a filter has been installed. If that doesn't work, the source will be cancelled permenently.
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Based on observation and records review the licensee did not complay with the regulation above in two of two water outlets in the school age center. The LPA observed the water was operable and accessible and the test results show that the lead level is above 5.5 ppb.
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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:Patricia Magana
LICENSING EVALUATOR NAME:Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2024


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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HILLCREST COUNTRY DAY SCHOOL
FACILITY NUMBER: 191595372
VISIT DATE: 02/13/2024
NARRATIVE
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Census at the time of the visit was five school age children. A review of the Facility Personnel Report Summary indicated all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to the initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Based on interview statements and records review, the licensee did not address the lead exceedance in water source(s) B and J of the school age center. The Written Directives Section 101704 Lead Action Level Exceedance Response Requirements of California Lead Action Level at Child Care Centers was cited on the attached LIC 809D due to Lead Action Level Exceedance with values of 5.5 ppb or greater.

An exit interview was conducted, and the report was reviewed with the director. A Notice of Site Visit was posted and must remain posted for 30 days. Appeal Rights and deficiency were explained. The Director was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024
LIC809 (FAS) - (06/04)
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