KIDDO LAND LEARNING CENTER

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 January 17, 2022, License Program Analyst (LPA) Melanie Otsuji met with Director Moon Chia for an UNANNOUNCED CASE MANAGEMENT INSPECTION for Lead Testing Results. Present for today's inspection was the Director, 9 staff members and 27 preschool aged children. The facility operates Monday - Friday from 8:30 AM - 6:00 PM. LPA and Director toured the facility and LPA obtained photos of the faucets that have exceeded 5.5 ppb. It was indicated that an area exceeded the Action Level established by the state for lead exposure. A Plan of correction was discussed with the Director. This facility is being given a TYPE B citation (see 809-D) The two faucets that exceeded the Action Level are faucets D (adult bathroom hand washing sink) & E (sink used for washing items) A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the Director, Moon Chia. SUPERVISORS NAME: Wynn Norona LICENSING EVALUATOR NAME: Melanie Otsuji LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023 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: KIDDO LAND LEARNING CENTER FACILITY NUMBER: 013415189 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 01/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 02/17/2023 Section Cited HSC 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1) Lead Testing Written Directive- A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.1 2 3 4 5 6 7Director is to have water outlets (D and E) repaired and/or replaced. Once outlets have been repaired/replaced, Director is to obtain a follow up water sample following Written Directives, Section 101705. Follow Up sample shall be done prior to 2/17/2023 if possible. Director is to keep LPA 8 9 10 11 12 13 14This requirement is not met as evidenced by: Based on record review, facility had 2 outlets of water test 5.5 ppb or greater (neither of which are used for drinking water/food preparation), which is a potential health and safety risk to persons in care. 8 9 10 11 12 13 14up to date on repair/replacement and testing progress. 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:Wynn Norona LICENSING EVALUATOR NAME:Melanie Otsuji LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023

Type B citation - potential risk if not corrected

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 January 17, 2022, License Program Analyst (LPA) Melanie Otsuji met with Director Moon Chia for an UNANNOUNCED CASE MANAGEMENT INSPECTION for Lead Testing Results. Present for today's inspection was the Director, 9 staff members and 27 preschool aged children. The facility operates Monday - Friday from 8:30 AM - 6:00 PM. LPA and Director toured the facility and LPA obtained photos of the faucets that have exceeded 5.5 ppb. It was indicated that an area exceeded the Action Level established by the state for lead exposure. A Plan of correction was discussed with the Director. This facility is being given a TYPE B citation (see 809-D) The two faucets that exceeded the Action Level are faucets D (adult bathroom hand washing sink) & E (sink used for washing items) A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the Director, Moon Chia. SUPERVISORS NAME: Wynn Norona LICENSING EVALUATOR NAME: Melanie Otsuji LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023 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: KIDDO LAND LEARNING CENTER FACILITY NUMBER: 013415189 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 01/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 02/17/2023 Section Cited HSC 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1) Lead Testing Written Directive- A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.1 2 3 4 5 6 7Director is to have water outlets (D and E) repaired and/or replaced. Once outlets have been repaired/replaced, Director is to obtain a follow up water sample following Written Directives, Section 101705. Follow Up sample shall be done prior to 2/17/2023 if possible. Director is to keep LPA 8 9 10 11 12 13 14This requirement is not met as evidenced by: Based on record review, facility had 2 outlets of water test 5.5 ppb or greater (neither of which are used for drinking water/food preparation), which is a potential health and safety risk to persons in care. 8 9 10 11 12 13 14up to date on repair/replacement and testing progress. 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:Wynn Norona LICENSING EVALUATOR NAME:Melanie Otsuji LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023