THOMAS EDISON ELEMENTARY SCHOOL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On April 4, 2024 at approximately 3:30pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, case management visit. LPA met with site supervisor, Geraldine Mulunay, and explained the purpose of the visit. Present during visit included 4 preschool children with site supervisor and 1 teaching staff. Preschool program operates at Thomas Edison Elementary in KB classroom only. Children have access to drinking water at facility through a water pitcher that is refilled in classroom through a sink or water fountain. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. Facility completed lead water testing March 9, 2024, past the testing due date of January 1, 2023. Water fixture tested is below the 5.5ppb threshold. LPA referred facility representative to the Department website for lead: Toxicity Prevention and Water Testing Information. Facility is being cited a Type B citation for completing lead water testing requirement after due date. Water fixture tested is below the 5.5ppb threshold. Deficiency will be cleared on this date. A notice of site visit was given and must remain posted for 30 days. Appeal Rights were also provided. Exit interview conducted and report was reviewed with the facility representative, Geraldine Malunay. SUPERVISORS NAME: Marie Rodriguez LICENSING EVALUATOR NAME: Catrina Quimbo LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024 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 FACILITY NAME: THOMAS EDISON ELEMENTARY SCHOOL FACILITY NUMBER: 414004138 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/04/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/04/2024 Section Cited HSC 1597.16(a)(1) 1 2 3 4 5 6 7HSC 1597.16(a)(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:1 2 3 4 5 6 7Facility completed lead water testing March 9, 2024. Water fixture tested is below the 5.5ppb threshold. Deficiency cleared on same date. 8 9 10 11 12 13 14Based on interview and record review, the licensee did not comply with the section cited above by not completing lead testing by January 1, 2023 which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Marie Rodriguez LICENSING EVALUATOR NAME:Catrina Quimbo LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On April 4, 2024 at approximately 3:30pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, case management visit. LPA met with site supervisor, Geraldine Mulunay, and explained the purpose of the visit. Present during visit included 4 preschool children with site supervisor and 1 teaching staff. Preschool program operates at Thomas Edison Elementary in KB classroom only. Children have access to drinking water at facility through a water pitcher that is refilled in classroom through a sink or water fountain. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. Facility completed lead water testing March 9, 2024, past the testing due date of January 1, 2023. Water fixture tested is below the 5.5ppb threshold. LPA referred facility representative to the Department website for lead: Toxicity Prevention and Water Testing Information. Facility is being cited a Type B citation for completing lead water testing requirement after due date. Water fixture tested is below the 5.5ppb threshold. Deficiency will be cleared on this date. A notice of site visit was given and must remain posted for 30 days. Appeal Rights were also provided. Exit interview conducted and report was reviewed with the facility representative, Geraldine Malunay. SUPERVISORS NAME: Marie Rodriguez LICENSING EVALUATOR NAME: Catrina Quimbo LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024 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 FACILITY NAME: THOMAS EDISON ELEMENTARY SCHOOL FACILITY NUMBER: 414004138 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/04/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/04/2024 Section Cited HSC 1597.16(a)(1) 1 2 3 4 5 6 7HSC 1597.16(a)(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:1 2 3 4 5 6 7Facility completed lead water testing March 9, 2024. Water fixture tested is below the 5.5ppb threshold. Deficiency cleared on same date. 8 9 10 11 12 13 14Based on interview and record review, the licensee did not comply with the section cited above by not completing lead testing by January 1, 2023 which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Marie Rodriguez LICENSING EVALUATOR NAME:Catrina Quimbo LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024

Type B citation - potential risk if not corrected