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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413304
Report Date: 08/17/2022
Date Signed: 08/17/2022 12:25:06 PM

Document Has Been Signed on 08/17/2022 12:25 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CAROUSEL KIDS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
197413304
ADMINISTRATOR:RANASINGE, LYNETTEFACILITY TYPE:
830
ADDRESS:6326 LINDLEY AVENUETELEPHONE:
(818) 881-2721
CITY:ENCINOSTATE: CAZIP CODE:
91316
CAPACITY: 16TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
08/17/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:22 AM
MET WITH:Lynette Ranasinghe, DirectorTIME COMPLETED:
12:45 PM
NARRATIVE
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An unannounced, Case management deficiencies inspection was conducted on this date by Licensing Program Analyst (LPA) Shandra Powell in order to cite for deficiencies. This is a combination center with Infant program which includes a Preschool license ages 2 to 6. Preschool license #1974083740

Upon LPAs arrival, LPA was greeted by staff Caritina Castro who permitted LPA to enter the Center.

LPA and staff wore face coverings the duration of the inspection as a precautionary measure against COVID-19. The COVID screening questions were posed and all were responded to with "No."

Director Lynette Ranasinghe guided LPA on a tour of the Infant classroom to take census. In the Infant Room, there were 4 infants with one staff.

The Center is being cited per a directive issued by CDSS CCL CCC Water Testing, which stated that the facility water testing has a lead exceedance-referred to as an Action Level Exceedance (ALE) of over 5 parts per billion. This is a immediate risk to children in care. A citation has been issued.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CAROUSEL KIDS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 197413304
VISIT DATE: 08/17/2022
NARRATIVE
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During the inspection, Director provided LPA a copy of the External Water Sampler Self-Certification Form (LIC9275) completed and signed on 06/15/22 by Water Sampler the Facility Sketch was also attached to copy. During the inspection the Director also contacted water testing company California Rural Water Association (CRWA) to receive a hard copy of the report with results of all water testing from the CRWA.

LPA observed the drinking water fountain in the preschool outside play area has been dismantled and made inoperable. (Photos Taken).

Director stated children bring their own individual Sippy Cups filled with water each day. LPA observed a water filter located in kitchen in preschool area per Director the filter is used for drinking water at this time for both programs when needed.

LPA provided Director with a copy of FACT SHEET: AB 2370- Water Testing Requirements and How to Apply for Free Services (updated 7/27/2022).

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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Document Has Been Signed on 08/17/2022 12:25 PM - It Cannot Be Edited


Created By: Shandra Powell On 08/17/2022 at 11:51 AM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CAROUSEL KIDS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 197413304

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2022
Section Cited
CCR
101238(a)

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BUILDINGS AND GROUNDSThe child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

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Director stated will buy bottle water for center to use for drinking. Director will also contact California Rural Water Association (CRWA) to obtain report and assistance with funding for new fixures and guidance.
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This requirement is not met as evidenced by: Water testing report identified facility with a lead exceedance over 5 parts per billion (ppb)
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Director will request a waiver for use of bottle at this time. By POC 08/19/2022 director will email photos of bottled water and send waiver information to LPA.

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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:Karren Starks
LICENSING EVALUATOR NAME:Shandra Powell
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022


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