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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021210
Report Date: 02/09/2024
Date Signed: 02/09/2024 11:52:45 AM

Document Has Been Signed on 02/09/2024 11:52 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:CHILD ED CTR SCHOOL AGE CHILD CARE AT CALTECHFACILITY NUMBER:
198021210
ADMINISTRATOR:CAIN-CHANG, LISAFACILITY TYPE:
840
ADDRESS:240 SOUTH MICHIGAN AVENUETELEPHONE:
(818) 354-3418
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY: 23TOTAL ENROLLED CHILDREN: 23CENSUS: 0DATE:
02/09/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Erin Levinn - Preschool DirectorTIME COMPLETED:
12:10 PM
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Licensing Program Analysts (LPAs) Nolan Tcheng and Saul Valenzuela conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. Upon Arrival at 10:40am, LPA met with Preschool Director Erinn Levin, who guided LPA on a tour of the facility. There were no children present during the time of the inspection.

LPA 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 during today’s inspection.

On 11/15/2023, 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 11/15/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

· A - Kitchen Sink Faucet - Test results of 5.71ppb.

Director states that the staff flushes the water from the kitchen sink 3-4 times a day. There is a log kept on the fridge in the kitchen. Picture was obtained. The sink is currently used as a food prep outlet where they wash fruits and dishes. They utilize a tabletop Brita filter dispenser as well to help with providing drinking water to children in care. Per Director, the faucet was replaced on 11/11/2024, prior to testing. Testing conducted on 11/15/2024 showed result of 5.71ppb but an immediate flush was conducted on the same that resulted in <1ppb. Copies of the maintenance request were obtained. There was another water sample taken on 02/01/2024. The results did not have a lead exceedance.

REPORT CONTINUES PAGE 1 of 2

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILD ED CTR SCHOOL AGE CHILD CARE AT CALTECH
FACILITY NUMBER: 198021210
VISIT DATE: 02/09/2024
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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 visit

https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Due to the faucet being used as food preparation prior to its replacement, children in care were exposed to action level exceedance of lead.

The deficiency listed on the following page were observed by the LPA 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.

Notice of Site Visit was provided and must remain post for 30 consecutive days. A copy of PIN 21-21-CCP and appeal rights were provided to facility today.

An exit interview conducted with Director Erinn Levin, at 11:50amand a copy of this report was provided.

END OF REPORT PAGE 2 of 2

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/09/2024 11:52 AM - It Cannot Be Edited


Created By: Nolan Tcheng On 02/09/2024 at 11:20 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: CHILD ED CTR SCHOOL AGE CHILD CARE AT CALTECH
FACILITY NUMBER: 198021210

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/12/2024
Section Cited
CCR
101700.3(b)(1)

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Testing results with fractional ppb readings of 5.5 ppb or greater shall be rounded up to the nearest whole number...(1) A result with values of 5.5 or greater shall be deemed and Action Level Exceedance

This requirement is not met as evidenced by:
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Per Director, the faucet was replaced and work order was provided. Water filter is used and Arrowhead provided gallons are being used as drinking water. There was another testing conducted on 02/01/2024 and there was no action level exceedance. POC cleared on this date
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Based on record review, observation, and interview, Licensee did not sure that children were made inaccessbile to water with lead exceedance, via food preparation. This was a potential risk to the health, safety, and personal rights 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:Claudia Guangorena
LICENSING EVALUATOR NAME:Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2024


LIC809 (FAS) - (06/04)
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