<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020113
Report Date: 11/04/2024
Date Signed: 11/04/2024 12:20:16 PM

Document Has Been Signed on 11/04/2024 12:20 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:HOLLYWOOD PRESCHOOL & KINDERGARTENFACILITY NUMBER:
198020113
ADMINISTRATOR/
DIRECTOR:		FAZEENA RAZIKEENFACILITY TYPE:
850
ADDRESS:1528 N. WILTON PLACETELEPHONE:
(714) 317-4309
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 8DATE:
11/04/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:10 AM
MET WITH:Fazeena Razikeen, DirectorTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On November 4, 2024, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with facility director, Fazeena Razikeen, during the visit. Also present in the facility were 9 children and 2 teachers/staff. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility.

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 09/23/24

On 10/31/2024, 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 02/14/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

A – Water Fountain (52.700 UG/L) – Water fountain faucet was completely removed.

Director stated that the drinking fountain was never used the children/staff. However, the facility had the drinking fountain tested on 02/14/2023. The director completely removed the drinking fountain to make it inaccessible for children in care.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HOLLYWOOD PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198020113
VISIT DATE: 11/04/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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

See LIC809D for Type B deficiency cited. The facility has already corrected the deficiency by completely removing the drinking fountain. The facility provided proof of the correction to LPA on 09/23/2024.

Exit interview conducted and report was reviewed with the facility representative, Director Fazeena Razikeen. Appeal rights were provided to facility today. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 11/04/2024 12:20 PM - It Cannot Be Edited


Created By: Monique Jessica Ayala On 11/04/2024 at 11:43 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: HOLLYWOOD PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 198020113

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/04/2024
Section Cited
CCR
101700.3(b)(1)

1
2
3
4
5
6
7
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 evidence by:
1
2
3
4
5
6
7
The director completely removed the drinking fountain making it inaccessible for children in care.
8
9
10
11
12
13
14
Based on record review, the licensee did not comply with the directive above, as one outlet five outlets tested with an Action Level Exceedance (ALE). This poses an immediate Health and Safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2024


LIC809 (FAS) - (06/04)
Page: 3 of 3