<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191801470
Report Date: 04/25/2024
Date Signed: 05/31/2024 10:17:55 AM

Document Has Been Signed on 05/31/2024 10:17 AM - 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:ORIENTAL MISSION CHURCH NURSERY SCH00LFACILITY NUMBER:
191801470
ADMINISTRATOR/
DIRECTOR:		NO, HANNAHFACILITY TYPE:
850
ADDRESS:424 N. WESTERN AVE.TELEPHONE:
(323) 466-8046
CITY:LOS ANGELESSTATE: CAZIP CODE:
90004
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 15DATE:
04/25/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Eileen KimTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Director Eileen Kim.

During the inspection 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

Facility already provided a copy of the facility sketch, LIC 9276, and LIC 9275 to LPA Lee by the POC date since they just received the results from the testing vendor today.

On 04/09/2024, 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 03/30/2024. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

Sample A. Faucet in the located in the kitchen sink (6.1 UG/L) – Fountain currently not in use.

Since the other Faucet located in the same kitchen (Sample B .58 UG/L) did not have lead exceedance, the Director stated that the facility will only use the kitchen faucet (sample B) and will not use the other faucet (Sample A) until it has been retested. The test results indicated that sample C was not tested due to the facility planning on removing this faucet.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: ORIENTAL MISSION CHURCH NURSERY SCH00L
FACILITY NUMBER: 191801470
VISIT DATE: 04/25/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
A deficiency was cited on attached LIC809-D. The deficiency listed on the following page were reviewed by the LPA and is being cited in accordance with California Code of Regulations Title 22. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

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 Director Eileen Kim. Appeal rights discussed and explained.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/31/2024 10:17 AM - It Cannot Be Edited


Created By: Seung Lee On 04/25/2024 at 01:29 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: ORIENTAL MISSION CHURCH NURSERY SCH00L
FACILITY NUMBER: 191801470

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/09/2024
Section Cited
CCR
101700.3(b)(1)

1
2
3
4
5
6
7
 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 was not met as evidenced by the fact that sample A
1
2
3
4
5
6
7
The Director stated that the facility will take action to retest sample A. The Director also stated that sample C will be removed since it was not retested on 03/30/2024.
8
9
10
11
12
13
14
did not pass the retest on 03/30/2024 per results from the waterboard. This is a potential risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Seung Lee
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2024


LIC809 (FAS) - (06/04)
Page: 3 of 3