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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019560
Report Date: 02/22/2024
Date Signed: 02/22/2024 11:03:35 AM

Document Has Been Signed on 02/22/2024 11:03 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:AZUSA UNIFIED SCHOOL DISTRICT-MAGNOLIA CSPPFACILITY NUMBER:
198019560
ADMINISTRATOR:JENNY LEFACILITY TYPE:
850
ADDRESS:945 E. NEARFIELDTELEPHONE:
(626) 815-4700
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY: 60TOTAL ENROLLED CHILDREN: 24CENSUS: 22DATE:
02/22/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Prinicipal Marcella Fonseca, Director Jenny Le TIME COMPLETED:
11:45 AM
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On 02/22/2024, at 8:30 PM, Licensing Program Analyst (LPA)Mary Silva conducted an unannounced case
management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA
met with facility principal Marcella Fonseca and director Jenny Le, whom the reason for the visit was explained. LPA was lead on a tour of the facility. LPA observed 22 children and 3 staff. Preschool 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 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 on 01/28/24
On 12/14/2023, 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 10/25/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead
exceedance levels were as follows: D– Sink Faucet in Building C, Room 2 North (30.7 UG/L) – Faucet currently not in use.

Director stated that the facility does not use the sink faucet in the teacher work room. Per director the teacher work room is used to store art supplies, toys, and other equipment. Children don’t have access to the work room. The sink faucet labeled D was covered with a plastic bag making it inaccessible to staff and children upon learning the outlet had exceeding acceptable levels of lead. LPA obtained a photograph of the covered faucet. Per director the children bring own water bottles, and the preschool provides water from a water jug when children are indoors and outdoors. Director stated the water outlet labeled D was remediated on November 10 2023 and will be retested._____________________________Page 1______________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: AZUSA UNIFIED SCHOOL DISTRICT-MAGNOLIA CSPP
FACILITY NUMBER: 198019560
VISIT DATE: 02/22/2024
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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 visithttps://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Based on the LPA’s observations and records reviews, the following deficiencies listed on the attached LIC 809D(deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, a copy of the report, PIN 21-21-CCP and appeal rights was provided to Principal Marcella Fonseca and Director, Jenny Le.
____________________________Page 2____________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/22/2024 11:03 AM - It Cannot Be Edited


Created By: Mary Silva On 02/22/2024 at 10:00 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: AZUSA UNIFIED SCHOOL DISTRICT-MAGNOLIA CSPP
FACILITY NUMBER: 198019560

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/22/2024
Section Cited
CCR
101700.3(b)(1)

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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..., 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
is not met as evidenced by:
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Director stated sink faucet labeled D located in the teacher's workroom was remediated on 11/10/2023 and will be retested before use. Director will submit copy of work order and will provide the status by POC due date of 03/22/24
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Based on record review, the licensee did not comply with the directive above, as one out of four outlets tested with an Action Level Exceedance (ALE).
Outlet labeled D is located in the teacher work room. This poses a potential Health and Safety risk to children 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:Christina Gabelman
LICENSING EVALUATOR NAME:Mary Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2024


LIC809 (FAS) - (06/04)
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