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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370335
Report Date: 08/16/2022
Date Signed: 08/16/2022 10:36:44 AM

Document Has Been Signed on 08/16/2022 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GARDEN GROVE UNIFIED SCHOOL DISTRICT/LAWRENCEFACILITY NUMBER:
304370335
ADMINISTRATOR:KAWAI, JULIEFACILITY TYPE:
850
ADDRESS:12521 MONROE STREETTELEPHONE:
(714) 663-6255
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 16DATE:
08/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Principal Julie Kawai
Lead teacher Brianna Miller		TIME COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) Tina Nguyen and LPA Patricia Duron conducted an unannounced Case Management visit. LPA met with Lead teacher Brianna Miller to discuss the Lead Sampling Testing conducted on 06/24/22. During the inspection, LPA Nguyen talked to Director of Early Childhood Education Emma Druitt on the phone. Director Emma Druitt was advised on 08/10/2022 that the Lead Sample Report was to be posted. LPA confirmed that Director had posted the Lead Sample Report. The facility closed from June 1, 2022 to August 14, 2022 for summer break.

Director Emma and lead teacher stated the outlet with high levels of lead are inoperable. They have made the faucets/outlets that tested with high levels of Lead inoperable via plastic bag wrapped around the drinking faucet, taped all around and a sign “DO NOT USE”. The school will continue to have the children to bring their own water. Lunch was provided by school district kitchen . The children are using the faucets/outlets that do not exceed the level of lead to wash their hands. Director indicated that an outlet (faucet) that tested with a lead exceedance (ALE) will not be used for drinking or food preparation.

Director stated they have contacted the school district to re-test, will come up with a plan to fix the identified outlets and will re-test after fixing before putting those outlets back into use.
In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Exit interview conducted and report was reviewed with the facility representative. A notice of site visit was given and must remain posted for 30 days.


Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) 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: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2022
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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