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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270468
Report Date: 03/08/2023
Date Signed: 03/08/2023 10:09:45 AM

Document Has Been Signed on 03/08/2023 10:09 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:WESTMINSTER SCHOOL DISTRICT-DEMILLE SCHOOLFACILITY NUMBER:
304270468
ADMINISTRATOR:TRAN-PHUNG, ANNFACILITY TYPE:
850
ADDRESS:15400 VAN BUREN ST.TELEPHONE:
(714) 894-7224
CITY:MIDWAY CITYSTATE: CAZIP CODE:
92655
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 11DATE:
03/08/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Early Education Program Supervisor, Michelle Miller TIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA), Cindy Nguyen conducted an unannounced Case Management visit for the purpose to discuss the Lead Sampling Testing conducted on 2/09/2023. LPA Nguyen met with Early Education Program Supervisor, Michelle Miller. Census was taken and there were 2 preschool staff and 11 preschool age children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. LPA discussed the Lead Sampling Testing conducted on 02/09/23. Early Education Program Supervisor, Michelle Miller was advised on 03/06/2023 that the Lead Sample Report was to be posted. Early Education Program Supervisor provided LPA’s copies of all documentation requested regarding Lead; LIC 999 Facility Sketch, LIC 9275 and LIC 9276. LPA confirmed that facility had posted the Lead Sample Report during visit on 03/08/2023.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test. Community Care Licensing was notified that lead water testing conducted at the facility on 09/2722 failed allowable limit for lead. The purpose of today’s visit is to follow up lead testing results of Action Level Exceedance (ALE).

Instructions for required lead testing are outlined in PIN 21-21-CCP. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations.

Child Care Centers are expected to use an Environmental Laboratory Accreditation Program (ELAP), for lead testing. Accreditation from the California Environmental Laboratory Accreditation Program, known as an ELAP laboratory, is equipped to measure the amount of lead in parts per billion (ppb) unit of measurement.

Continued on Page LIC 809C

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2023
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: WESTMINSTER SCHOOL DISTRICT-DEMILLE SCHOOL
FACILITY NUMBER: 304270468
VISIT DATE: 03/08/2023
NARRATIVE
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Page LIC 809C

Early Education Program Supervisor stated the outlets with high levels of Lead are inoperable. Outlet A and B are sinks in the kitchen and it is not use for food preparation. The children’s food gets delivered and placed in hot boxes. Outlet C is a drinking fountain in Room 7. Room 7 has not been occupied since June 18, 2022. Room 7 has been under construction. Room 22 does not have running water in the classroom. All the children bring their own water and bottled water has been purchased for room 22 in case children need water.

Based on LPA's observation, record reviews and interview with the Early Education Program Supervisor, the following violation was observed and is being cited in accordance with Written Directives Section 101700.3 (b)(1) California Lead Action Level at Child Care Centers, is being cited on the attached LIC 809D.



Exit interview conducted and report was reviewed with Early Education Program Supervisor, Michelle Miller. A notice of site visit was given and must remain posted for 30 days. Appeal Rights and deficiency were explained. The Director was provided a copy of appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
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Document Has Been Signed on 03/08/2023 10:09 AM - It Cannot Be Edited


Created By: Cindy Nguyen On 03/08/2023 at 08:37 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: WESTMINSTER SCHOOL DISTRICT-DEMILLE SCHOOL
FACILITY NUMBER: 304270468

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/07/2023
Section Cited

101700.3(b)(1)

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101700.3 California Lead Action Level at Child Care Centers (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, 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 was not met as evidenced by:
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Room 22 does not have running water in the classroom. All the children bring their own water and bottled water has been purchased for room 22 in case children need water. No food prep in the kitchen sink at DeMille school. The children’s food get delivered to DeMille and placed in hot boxes.
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Lab report analysis water from outlet A (21.800.0 ppb), outlet B (6.470) and outlet C (6.310 ppb) taken on 02/09/2023 indicated levels of lead in exceedance. This poses a potential risk to the health and safety of children in care.
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Administration will retest, replace or repair outlet A, B, C and will submit resampling results to LPA. Please refer to the 101704 Lead Action Level Exceedance Response Requirements PIN provided today.

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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:Patricia Magana
LICENSING EVALUATOR NAME:Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2023


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