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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021231
Report Date: 05/10/2024
Date Signed: 05/10/2024 10:36:52 AM

Document Has Been Signed on 05/10/2024 10:36 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:BRIDGE MONTESSORI PRESCHOOLFACILITY NUMBER:
198021231
ADMINISTRATOR/
DIRECTOR:		CYNTHIA DAVILAFACILITY TYPE:
850
ADDRESS:393 N LAKE AVENUETELEPHONE:
(626) 817-2205
CITY:PASADENASTATE: CAZIP CODE:
91101
CAPACITY: 160TOTAL ENROLLED CHILDREN: 160CENSUS: 14DATE:
05/10/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Lydia Nandakumaran - OwnerTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Nolan Tcheng and Portia Bowden conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. Upon Arrival at 9am, LPA met with Lydia Nandakumaran, who guided LPA on a tour of the facility. There were children present during the time of the inspection.

Census was taken. LPA observed 14 children with 2 staff members.

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 04/16/2024, 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 04/06/2024. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

· A - Lounge (Room 105) Water Outlet - Test Result 15ppb

Owner states that there is no food preparation conducted on site. Water policy is that children will bring their own water bottle from home. There is a large filtered water jug that is ordered from a water company in Pasadena. Water from facility water outlets are not used for drinking or food preparation. At this time, Water Outlet A is in an unused room, 105. Room 107 is the only classroom currently in use and has been the only classroom used since their licensing on 07/11/2023.

REPORT CONTINUES PAGE 1 of 2

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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: BRIDGE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198021231
VISIT DATE: 05/10/2024
NARRATIVE
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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

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 Owner Lydia Nandakumaran, at 10:33am, and 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: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/10/2024 10:36 AM - It Cannot Be Edited


Created By: Nolan Tcheng On 05/10/2024 at 10:17 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: BRIDGE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198021231

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/17/2024
Section Cited
CCR
101700.3(b)(1)

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101700.3 (b)(1)
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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During the water sampling date, 04/06/2024, the water sampler conducted a flush and retested water outlet A (now A30), and the result came back as lower tham the Action Level exceedance threshold. POC letter was provided to facility on this date.
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Based on recrod review and interview, the licensee did not ensure that the water outlets in child care area Room 105, was inaccessible to children in care. This poses 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: 05/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2024


LIC809 (FAS) - (06/04)
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