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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021338
Report Date: 11/26/2024
Date Signed: 11/26/2024 04:51:17 PM

Document Has Been Signed on 11/26/2024 04:51 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:MARYVALE AT EPIPHANYFACILITY NUMBER:
198021338
ADMINISTRATOR/
DIRECTOR:		MOORE, CHRISTINAFACILITY TYPE:
850
ADDRESS:10915 MICHAEL HUNT DRIVETELEPHONE:
(626) 537-3314
CITY:S. EL MONTESTATE: CAZIP CODE:
91733
CAPACITY: 24TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
11/26/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Site Supervisor, Ana Hernandez TIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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 Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in water fixtures in the facility. LPA met with Site Supervisor Ana Hernandez- who the purpose of the inspection was announced. Director Marcela Torres arrived at 3:45 pm and took over the inspection. Census was taken

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 representative 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.

On 9/14/2023 facility provided facility sketch and required forms LIC 9276, LIC 999 and LIC 9275 to the department along with application packet. On 11/20/2024, 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 8/22/2023. Faucets reported with 5.5 ppb or greater lead exceedance levels were as follows:-
  • Classroom Water fountain fixture D- CD-P (6.8 UG/L)

--------------------------------------------------------pg. 1 of 2 ------------------------------------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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 2
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: MARYVALE AT EPIPHANY
FACILITY NUMBER: 198021338
VISIT DATE: 11/26/2024
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Per Director, Facility was tested during the application process- they received results and removed water fountain prior to being licensed in January 10, 2024. On this date LPA observed that the water fountain has been removed. Facility Provides drinking water via water jug and dixie cups for children. Water jug is refilled by purifier in kitchen sink.

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

A notice of site visit was also provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative, Marcela Torres
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
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