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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400587
Report Date: 03/01/2024
Date Signed: 03/01/2024 02:10:56 PM

Document Has Been Signed on 03/01/2024 02:10 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ST ANNE'S EARLY LEARNING CENTER AT ABBOTTFACILITY NUMBER:
198400587
ADMINISTRATOR:ANNA LOPEZFACILITY TYPE:
830
ADDRESS:5262 CLARK STTELEPHONE:
(213) 381-2931
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 84TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
03/01/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Patricia Brizuela, Facility Representative (FR)TIME COMPLETED:
12:30 PM
NARRATIVE
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On 03/01/2024 at 11:30 AM, Licensing Program Analysts (LPAs) Katrina Chicote and Anthony Padilla conducted an Unannounced Case Management Inspection and met with Facility Representative(FR) Patricia Brizuela, Center Manager. LPAs disclosed the purpose of the inspection and was granted entry into the facility and was provided guided tour both indoors and outdoors. Facility is located on Abbott Elementary School Campus and made up of ten classrooms but, due to low enrollment, are currently using four classrooms: 1, 2, 7, and 8.

The purpose of today's inspection was to discuss the water lead test results. Results received by RO indicated multiple sources to have action level exceedance (ALE) of lead with results for the following: Sample CC with ALE of 7 ppb, Sample DD with ALE of 7 ppb, Sample GG with ALE of 6 ppb, Sample L with ALE of 6 ppb, Sample P with ALE of 8 ppb, and Sample V with ALE of 8 ppb. LPA Chicote notified Agency on 02/28/2024 of results received via email.

LPAs conducted a tour of the facility and observed sinks and drinking fountains available in each classroom. However, per FR, they provide filter water from the Kitchen which is then distributed through coolers in the classrooms. LPAs observed coolers with paper cups in each classroom at time of inspection. LPA Chicote received an email on response on 02/28/2024 with updated results indicating that all water sources have been remediated and since been retested on 03/08/2023 with results indicating that water sources no longer have ALE. In addition, email also states that water sources tested are not used for drinking or food preparation, FR states that food is delivered from District Central Kitchen and no food prep is done on site.

A deficiency was cited to ensure that the water sources with the exceedance will not be used as a drinking source or food preparation source for the children.

A notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted and report was reviewed with FR, Patricia Brizuela.
Report Ends - Page 1 of 1
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
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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Document Has Been Signed on 03/01/2024 02:10 PM - It Cannot Be Edited


Created By: Katrina Chicote On 03/01/2024 at 12:38 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ST ANNE'S EARLY LEARNING CENTER AT ABBOTT
FACILITY NUMBER: 198400587

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2024
Section Cited
HSC
101700.3(b)(1)

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101700.3(b)(1)
(b) Testing results with fractional ppb readings of 5.5 ppb or greater ..., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be... Action Level Exceedance. This requirement was not met as evidence by:
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FR states water sources with ALE have been remediated and retested on 03/28/2023 and no longer have ALE. LPA received documents with updated results in email clearing deficiency on this date.
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Based on record review the Licensee did not ensure water sources at facility to meet lead requirements. Lead test results received showed that multiple water sources has an action level exceedance. This poses a potential health, safety, and personal rights 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:Denise Gibbs
LICENSING EVALUATOR NAME:Katrina Chicote
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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