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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006301
Report Date: 09/14/2023
Date Signed: 09/14/2023 11:21:47 AM

Document Has Been Signed on 09/14/2023 11:21 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:FLINTRIDGE MONTESSORI PRE-SCHOOL & ELEMENTARY, INCFACILITY NUMBER:
198006301
ADMINISTRATOR:DAVID NIMALI ROHINIFACILITY TYPE:
850
ADDRESS:1739 FOOTHILL BOULEVARDTELEPHONE:
(818) 790-8844
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY: 85TOTAL ENROLLED CHILDREN: 85CENSUS: 75DATE:
09/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Nimali Rohini, DirectorTIME COMPLETED:
11:30 AM
NARRATIVE
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On 09/14/2023 at 9:31 AM, Licensing Program Analyst (LPA) Thelma Razo conducted an unannounced Case Management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. A COVID 19 risk assessment was conducted prior to entering the facility. LPA met with facility Director Nimali Rohini and stated the purpose of the visit. Also present in the facility were 75 day care children, 9 teachers and 1 assistant. Facility was within ratio & capacity.

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 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 9275, LIC9276 and LIC999 to LPA today. On 02/07/2023, 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 01/21/2023. Faucets and drinking fountain reported with 5.5 ppb or
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2023
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FLINTRIDGE MONTESSORI PRE-SCHOOL & ELEMENTARY, INC
FACILITY NUMBER: 198006301
VISIT DATE: 09/14/2023
NARRATIVE
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greater lead exceedance levels were as follows:

• Drinking faucet on the corner of the sink in Room 2 (16 UG/L) – LPA observed drinking fountain to be covered and inaccessible for children in care - picture was taken.
Director stated that the facility has not been using the water fountain during the pandemic in 2020. Children bring water bottles from home and facility has filtered water from the kitchen and bottled water. The drinking faucet was covered and secured with a plastic bag when the facility was informed by analyst that it was exceeding acceptable levels. Per Director, the drinking faucet will be capped.

Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit
https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information
A copy of PIN 21-21.1-CCP was given to Ms. Rohini.
A notice of site visit was also provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
A deficiency was cited per Title 22 of CA Code of Regulations. See LIC809D.
Exit interview conducted. Report and Appeal Rights were reviewed with Director Nimali Rohini.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/14/2023 11:21 AM - It Cannot Be Edited


Created By: Thelma Razo On 09/14/2023 at 11:08 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FLINTRIDGE MONTESSORI PRE-SCHOOL & ELEMENTARY, INC
FACILITY NUMBER: 198006301

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/28/2023
Section Cited
CCR
101700.3(b)(1)

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California Lead Action Level at Child Care Centers. (b) Testing results with fractional readings of parts per billion (ppb) 0.5 ppb or greater shall be rounded before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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During inspection, LPA observed the drinking faucet has been covered and secured with a plastic bag with sign that indicate that it's out of service. Per director children bring their own water and facility has bottled and filtered water for drinking. Director stated that it will be capped and proof will be sent to LPA on
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This requirement is not me at evidenced by the drinking faucet in room 2 tested with an Action Level Exceedance (ALE) of 16. This poses a potential health and safety risk to children in care.
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Plan of Correction due date 9/28/23.

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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Thelma Razo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2023


LIC809 (FAS) - (06/04)
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