198010922-1-9-2023-54-CC-AMOY-CMWRAU-20230109115143

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010922
Report Date: 01/09/2023
Date Signed: 01/09/2023 11:51:49 AM

Document Has Been Signed on 01/09/2023 11:51 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CUDAHY PRESCHOOL ACADEMY		FACILITY NUMBER:	198010922
ADMINISTRATOR:	ADOL VERGARA		FACILITY TYPE:	850
ADDRESS:	4912 CLARA ST		TELEPHONE:	(323) 771-8700
CITY:	CUDAHY	STATE: CA	ZIP CODE:	90201
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 20	CENSUS: 19	DATE:	01/09/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Adol Vergara, Director		TIME COMPLETED:	12:00 PM

NARRATIVE

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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced case management inspection on this date 01/09/23. LPA Mooberry met with Adol Vergara, Director, who guided LPA on a tour of the facility. Juan De Anda, Program Administrator called by phone during inspection. There were 19 children present and 4 staff during the inspection.

The purpose of this inspection is to discuss the facility's water lead test results received on 12/21/22. Results show that a water source in the facility had Action Level Exceedance (ALE) of lead.

The sink located in classroom B-7 was determined to have a lead result of 11.2 parts per billion (ppb). A result with values of 5.5 parts per billion (ppb) or greater shall be deemed an Action Level Exceedance in accordance with the Lead Testing Written Directives section 101700.3 subsection (b)(1).Per Program Administrator, Juan De Anda, the sink faucet has never been used for drinking, food preparation or consumption. The facility has replaced the sink faucet and covered it with a plastic bag until the retesting.

The Director stated the faucet has only been used for hand washing and not for drinking or food preparation source. LPA observed water dispensers and filtered water with paper cups in all classrooms and kitchen. Director provided LPA copy of the facility sketch (identifying source of ALE), photos to show that the faucet has beencovered to prevent access from children. Director was advised to ensure children don't drink out of the faucet with ALE in Room B-7. Per director, parent will be notified of ALE and the facility plan to ensure health and safety of children in care.

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Exit interview conducted and report was reviewed with the Facility Representative Adol Vergara. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

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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