VOA/CORAZON DE LA FAMILIA

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 05/17/2023 Licensing Program Analyst (LPA) Doris Whitmore arrived at VOA/ Corazon Center to conduct an unannounced case management visit. The unannounced visit was for the North Hollywood main central kitchen.LPA Whitmore was met by Education Coordinator Nurly Gonzalez. LPA Whitmore informed the Education Coordinator about the purpose of the visit and was guided on a tour of the facility. There were 9 teachers and 55 children. 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. The Department was notified that the facility has been identified to have water outlets with an Action Level Exceedance (ALE) in the amount of lead in the water being 5.5 parts per billion (pbb), or greater. The purpose of today’s visit is to ensure that water outlets are not in use and there is a potable source of water for children and staff at the facility. On 05/16/2017, LPA Whitmore spoke to the Education Coordinator Nurly Gonzalez about the report. LPA Whitmore was able to obtain a copy of the report which included External Water Sample Self- Certification Form (LIC9275), Signed and dated Child Care Sampling Checklist Form(LIC9276), and Facility Sketch (fully labeled with locations of all waster outlets). Lead Water sample testing conducted by Terra Environmental. The facility was prep for water sampling on 10/03/2022, tested 10/07/2022 The lab collected the water sample on 10/07/2022. The facility received the results on 03/27/2023. Samples submitted to the Terra Environmental. Per the report, the following water outlets yielded the following reports: Kitchen Stick Skillet Cold Water Faucet During today's visit LPA observed that the facility currently is not using the Kitchen Stick Skillet Cold Water Faucet. SUPERVISORS NAME: Karren Starks LICENSING EVALUATOR NAME: Doris Whitmore LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023 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 3 FACILITY NAME: VOA/CORAZON DE LA FAMILIAFACILITY NUMBER: 197404016 VISIT DATE: 05/17/2023 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32LPA will upload documents to the CA State Control Board, Division of Drinking Water (DDW) data base. During today's visit LPA Whitmore conducted the tour of the facility and observed the Kitchen Stick Skillet Cold Water Faucet. Facility currently is not using the faucet. Based on observation, interviews and supportive documents it has been determined that VOA/ Corazon De La Familia Center ( Central Kitchen)violated Child Care Licensing Regulation Division 12 Chapter 1, Subchapter 5 1017003 (b) (1) California Lead Action Level at Child Care Centers. A result with values of 5.5ppb or greater shall be deemed an Action Level Exceedance. Lead water testing samples taken on 10/23/2022 reveled that levels of lead were beyond allowable amount deemed by the State of California. This facility is being cited (1) deficiency during today’s visit 05/17/2023. This is a type B violation which poses a potential Health, Safety, or Personal Rights risk to persons in care. Refer to LIC809-D for deficiency page. LPA discussed Proof of Correction (POC) with Education Coordinator Nury Gonzalez. For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb or call them at (510) 620-5600. Please see Provider Information Notice (PIN) 20-01-CCP for more information about lead toxicity prevention. Exit interview was conducted, report was reviewed with Education Coordinator Nury Gonzalez licensee was provided a copy of the report and appeal rights. SUPERVISORS NAME: Karren Starks LICENSING EVALUATOR NAME: Doris Whitmore LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023 FACILITY NAME: VOA/CORAZON DE LA FAMILIA FACILITY NUMBER: 197404016 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 05/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 05/17/2023 Section Cited CCR 101700.3(b)(1) 1 2 3 4 5 6 7 California Lead Action Level at Child Care Centers. A result with values of 5.5ppb or greater shall be deemed an Action Level Exceedance. This requirement is not

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 05/17/2023 Licensing Program Analyst (LPA) Doris Whitmore arrived at VOA/ Corazon Center to conduct an unannounced case management visit. The unannounced visit was for the North Hollywood main central kitchen.LPA Whitmore was met by Education Coordinator Nurly Gonzalez. LPA Whitmore informed the Education Coordinator about the purpose of the visit and was guided on a tour of the facility. There were 9 teachers and 55 children. 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. The Department was notified that the facility has been identified to have water outlets with an Action Level Exceedance (ALE) in the amount of lead in the water being 5.5 parts per billion (pbb), or greater. The purpose of today’s visit is to ensure that water outlets are not in use and there is a potable source of water for children and staff at the facility. On 05/16/2017, LPA Whitmore spoke to the Education Coordinator Nurly Gonzalez about the report. LPA Whitmore was able to obtain a copy of the report which included External Water Sample Self- Certification Form (LIC9275), Signed and dated Child Care Sampling Checklist Form(LIC9276), and Facility Sketch (fully labeled with locations of all waster outlets). Lead Water sample testing conducted by Terra Environmental. The facility was prep for water sampling on 10/03/2022, tested 10/07/2022 The lab collected the water sample on 10/07/2022. The facility received the results on 03/27/2023. Samples submitted to the Terra Environmental. Per the report, the following water outlets yielded the following reports: Kitchen Stick Skillet Cold Water Faucet During today's visit LPA observed that the facility currently is not using the Kitchen Stick Skillet Cold Water Faucet. SUPERVISORS NAME: Karren Starks LICENSING EVALUATOR NAME: Doris Whitmore LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023 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 3 FACILITY NAME: VOA/CORAZON DE LA FAMILIAFACILITY NUMBER: 197404016 VISIT DATE: 05/17/2023 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32LPA will upload documents to the CA State Control Board, Division of Drinking Water (DDW) data base. During today's visit LPA Whitmore conducted the tour of the facility and observed the Kitchen Stick Skillet Cold Water Faucet. Facility currently is not using the faucet. Based on observation, interviews and supportive documents it has been determined that VOA/ Corazon De La Familia Center ( Central Kitchen)violated Child Care Licensing Regulation Division 12 Chapter 1, Subchapter 5 1017003 (b) (1) California Lead Action Level at Child Care Centers. A result with values of 5.5ppb or greater shall be deemed an Action Level Exceedance. Lead water testing samples taken on 10/23/2022 reveled that levels of lead were beyond allowable amount deemed by the State of California. This facility is being cited (1) deficiency during today’s visit 05/17/2023. This is a type B violation which poses a potential Health, Safety, or Personal Rights risk to persons in care. Refer to LIC809-D for deficiency page. LPA discussed Proof of Correction (POC) with Education Coordinator Nury Gonzalez. For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb or call them at (510) 620-5600. Please see Provider Information Notice (PIN) 20-01-CCP for more information about lead toxicity prevention. Exit interview was conducted, report was reviewed with Education Coordinator Nury Gonzalez licensee was provided a copy of the report and appeal rights. SUPERVISORS NAME: Karren Starks LICENSING EVALUATOR NAME: Doris Whitmore LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023 FACILITY NAME: VOA/CORAZON DE LA FAMILIA FACILITY NUMBER: 197404016 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 05/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 05/17/2023 Section Cited CCR 101700.3(b)(1) 1 2 3 4 5 6 7 California Lead Action Level at Child Care Centers. A result with values of 5.5ppb or greater shall be deemed an Action Level Exceedance. This requirement is not

Type B citation - potential risk if not corrected