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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018199
Report Date: 02/29/2024
Date Signed: 02/29/2024 12:52:18 PM

Document Has Been Signed on 02/29/2024 12:52 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ST. ANNE'S EARLY LEARNING CENTER AT SAN MARINOFACILITY NUMBER:
198018199
ADMINISTRATOR:ELENA MEDINAFACILITY TYPE:
850
ADDRESS:3156 W. SAN MARINO STREETTELEPHONE:
(213) 381-2931
CITY:LOS ANGELESSTATE: CAZIP CODE:
90006
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
02/29/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Joaquin Mancilla, Lead Teacher TIME COMPLETED:
01:00 PM
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On 2/29/24 Licensing Program Analysts (LPAs) Staicy Perry and Monique Ayala conducted an unannounced case management inspection. A COVID 19 risk assessment was conducted. LPAs met with Lead teacher Joaquin. LPA observed 0 children with 1 staff (Lead Teacher) in care. Facility operates M-F from 7:00am-12:00pm.

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.

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 7.27.2023. Drinking faucet located in Classroom #1 reported with 5.5 ppb or greater lead exceedance level were as follows:

· During this inspection, water outlet “J” located in Classroom #1, was observed to be replaced. LPA took a photo of the Water Drinking Facet.

The purpose of today's inspection is to go over the water lead test results.Facility has tested for lead December 6, 2022, and had an exceedance in facet labeled letter “J” which had an exceedance of 6. Once facility was notified of exceedance the facet “J” was immediately capped, yellow caution tape around the sink and a sign that indicated “Do Not Use.” A retest was completed 3/15/24 with a test result of 0.52 for faucet “J” which is with in regulation. Facility has replaced the faucet. LPAs received via email all documentation regarding LEAD results.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/29/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ST. ANNE'S EARLY LEARNING CENTER AT SAN MARINO
FACILITY NUMBER: 198018199
VISIT DATE: 02/29/2024
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LPAs did observe blue Igloo water jug and small cups for the children and were seen to be accessible.

LPA, Staicy Perry received all documentation, including facility sketch, LIC9276, LIC9275, photos and test results during today’s visit.

A deficiency was cited on attached 809D. The deficiency listed on the following page were observed by the LPAs and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given to licensee and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Lead Teacher Joaquin Mancilla.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
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Document Has Been Signed on 02/29/2024 12:52 PM - It Cannot Be Edited


Created By: Staicy Perry On 02/29/2024 at 12:36 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: ST. ANNE'S EARLY LEARNING CENTER AT SAN MARINO
FACILITY NUMBER: 198018199

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/29/2024
Section Cited
CCR
101700.3

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101700.3(b)(1) California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater... (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance
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LPAs observed that the Water Drinking Facet in Classroom #1 to have been replaced as well as retested.
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This requirement is not met as evidenced by: Based on testing results provided by the facility with an Action Level Exceedance (ALE) which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Claudia Guangorena
LICENSING EVALUATOR NAME:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


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