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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019940
Report Date: 03/14/2024
Date Signed: 03/14/2024 02:14:34 PM

Document Has Been Signed on 03/14/2024 02:14 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DISCOVERY WORLD MONTESSORIFACILITY NUMBER:
198019940
ADMINISTRATOR:JIA JIA CHENFACILITY TYPE:
830
ADDRESS:801 BREA CANYON RDTELEPHONE:
(909) 598-5540
CITY:DIAMOND BARSTATE: CAZIP CODE:
91789
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: DATE:
03/14/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:23 PM
MET WITH:Gina FontanillaTIME COMPLETED:
02:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jennifer Hua conducted an unannounced case management inspection. LPA met with director Gina Fontanilla. The purpose of the visit was announced.

The purpose of today's inspection is to go over the water lead test results received on 4/17/2023. Results indicate that outlets had action level exceedance of lead. Outlet J - playground drinking fountain had a lead result of 9.37 ppb. Outlet F - Classroom #3 faucet had a lead result of 9.23 ppb and Outlet H - classroom #6 faucet had a lead result of 14.2 ppb.

Based on above, deficiency cited attached 809D.

An exit interview conducted, an exit interview conducted with Director. Notice of Site Visit form provided and shall be posted for 30 days in a prominent area.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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Document Has Been Signed on 03/14/2024 02:14 PM - It Cannot Be Edited


Created By: Jennifer Hua On 03/14/2024 at 01:54 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: DISCOVERY WORLD MONTESSORI
FACILITY NUMBER: 198019940

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2024
Section Cited
CCR
101700.3(c)

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California Lead Action Level at Child Care Centers. Licensee failed to maintain a lead value at or below the Action Level for water lead testing of 5.5 ppb or greater for outlet J, F, and H Result with values of 5.5 ppb or greater shall be deemed an Action Level
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Outlets have been retested and are at acceptable level. Lab results received.

Deficiency has been corrected.
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This requirement is not met as evidenced by: Water testing results identified with Action Level Exceedance as defined in WD section 101700.3 are not deemed safe to drink. This poses an potential risk to the health of safety of 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:Ana Chico
LICENSING EVALUATOR NAME:Jennifer Hua
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024


LIC809 (FAS) - (06/04)
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