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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020552
Report Date: 03/01/2024
Date Signed: 03/04/2024 08:38:59 AM

Document Has Been Signed on 03/04/2024 08:38 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/CHARLES LEEFACILITY NUMBER:
198020552
ADMINISTRATOR:JENNY LEFACILITY TYPE:
850
ADDRESS:550 N CERRITOS AVETELEPHONE:
(626) 815-4724
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY: 40TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
03/01/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Principal Diana RojasTIME COMPLETED:
03:55 PM
NARRATIVE
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On 03/01/2024, 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 Diana Rojas, whom the reason for the visit was explained. LPA was lead on a tour of the facility. LPA observed 7 children and 2 staff. Preschool was within ratio & capacity. This preschool has an afternoon program that operates from 12:10pm-3:10pm.

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 01/28/2024, 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 10/24/2023 and 02/15/2024. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

A–Pre-K Classroom-Drinking Fountain Sink Faucet (12.50 UG/L) – Faucet currently not in use.
A30–Pre-K Classroom-Drinking Fountain Sink Faucet (6.89 UG/L) – Faucet currently not in use.
B–Pre-K Classroom-South-Faucet (15.3 UG/L) – Faucet currently not in use.
C–Pre-K Classroom-North- Faucet (21.00 UG/L) – Faucet currently not in use.

__________________________Page 1___________________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2024
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/CHARLES LEE
FACILITY NUMBER: 198020552
VISIT DATE: 03/01/2024
NARRATIVE
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Principal stated that the facility was utilizing water outlet labeled A for drinking. This water outlet is located next to the classroom entrance. The water outlet labeled A30 is located in the Teacher’s work room and is not used for drinking water. The teacher work room is used to prepare art and craft activities. Children do not have access to the teacher’s work room. The water outlets labeled B and C are used for handwashing and are located outside of the classroom bathrooms. Principal stated children are using the water outlets in the preschool innovation lab for handwashing. Facility has water bottles available for drinking and children also bring own water bottles. When the facility was informed it was exceeding acceptable levels of lead the facility covered water outlets labeled A, A30, B, and C with plastic bags making them inaccessible to children and staff.

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

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 or 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 Diana Rojas.

______________________________Page 2______________________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/04/2024 08:38 AM - It Cannot Be Edited


Created By: Mary Silva On 03/01/2024 at 01:01 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: AZUSA UNIFIED SCHOOL DISTRICT/CHARLES LEE
FACILITY NUMBER: 198020552

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/01/2024
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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Principal stated facility will remediate outlets labeled A, A30, B & C and retested before use. Principal will continue to provide status and updates by POC due date of 04/01/24.
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Based on observation the licensee did not comply with the directive above, as four out of eight water outlets tested with an Action Level Exceedance (ALE).These water outlets are labeled A, A30, B and C. Water outlets have been covered and made inaccessible to children and staff. 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: 03/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024


LIC809 (FAS) - (06/04)
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