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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370174
Report Date: 09/16/2022
Date Signed: 03/23/2023 08:24:02 PM

Document Has Been Signed on 03/23/2023 08:24 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:LA HABRA HERITAGE SCHOOLFACILITY NUMBER:
304370174
ADMINISTRATOR:WIJEGUNARATNE, DEEPIKAFACILITY TYPE:
850
ADDRESS:323 NORTH EUCLID STREETTELEPHONE:
(562) 691-1967
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY: 51TOTAL ENROLLED CHILDREN: 51CENSUS: 24DATE:
09/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Director, Deepika WijegunaratneTIME COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analyst (LPA), Dianna Valdez-Santana conducted an unannounced Case Management visit for the purpose to discuss the Lead Sampling Testing conducted on 07/08/2022. LPA met with Director, Deepika Wijegunaratne, who was explained the reason for today’s visit. LPA observed 24 children in care.

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 07/08/2022 failed allowable limit for lead. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (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.


Facility staff was advised on 09/09/2022 that the Lead Sample Report was to be posted. LPA observed the facility had posted the Lead Sample Report.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2022
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: LA HABRA HERITAGE SCHOOL
FACILITY NUMBER: 304370174
VISIT DATE: 09/16/2022
NARRATIVE
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On 09/16/22 LPA spoke with Director, Deepika who stated that the one outlet that had ALE over 5.0 had been made inaccessible to children via, wooden block covering. Outlet C was a drinking fountain and it had a level of 15.0 is located in “Room 1”. The outlet has been made inaccessible and inoperable. As an alternate water source, the facility has a water delivery service so children and staff can refill their water bottles. In addition there are other sinks that “PASSED” with no high exceedance of lead that are readily available for children and staff.


Based on LPA’s Director interview, review of facility sketch and walk-through, the following violation was observed and is being cited in accordance with California Code of Regulations Title 22, Division 12, Chapter 3, Section 101700.3 California Lead Action Level at Child Care Centers is being cited on the attached LIC 809D.


Exit interview conducted with Director, Deepika. The report was reviewed and discussed. Appeal Rights were discussed. Facility staff was provided copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received to the Regional Office within 15 business days.

The staff was informed that the "Notice of Site Visit" must be posted for 30 consecutive days. The Notice of Site Visit must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022
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Document Has Been Signed on 03/23/2023 08:24 PM - It Cannot Be Edited


Created By: Dianna ValdezSantana On 09/16/2022 at 02:27 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LA HABRA HERITAGE SCHOOL
FACILITY NUMBER: 304370174

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/23/2022
Section Cited
CCR
101700.3

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101700.3 California Lead Action Level at Child Care Centers (b) Testing results with fractional ppb readings of 5.0 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.
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POC: Facility staff followed Written Directives in PIN 21-21 CCP for lead water testing. Licensing Forms completed; 9275, 9276 and facility sketch submitted. Notification will be to to parents and water outlet permanently removed on 09/10/22.
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Based on lab report analysis water from outlet C (15.0 parts per billion). Outlet samples were taken on 07/08/2022 indicate levels of lead in exceedance.
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Facility has a "Sparkletts" water delivery service in addition to the other PASS sinks, are readily available for the staff and children. Director stated that she will submit proof of parent notifcation and Outlet C removal documention to LPA via email to Dianna.valdezsantana@dss.ca.gov

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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:Thuy Ho
LICENSING EVALUATOR NAME:Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:
DATE: 09/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/16/2022


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