SHARMILA MONTESSORI HOUSE OF CHILDREN

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 November 16, 2023, Licensing Program Analyst (LPA) Garcia conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with owner Moderage Shamin Perera. LPA explained the purpose of the visits and was given a tour of the facility. Present in facility are 21 children, with 5 staff members. LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. The facility received the ALE report from the Vendor on October 7, 2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and barricaded and or made the affected fixture out of order. The affected fixtures are A(8), B(10), and C(13) parts per billion (ppb) of lead. Per director, fixture A and C are sinks located in the classrooms. Fixture B is garden hose used for watering plants or any outdoor water play. LPA also observed that the facility uses water services for food preparation and drinking. LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), sent in an email to the LPA. * See next page for deficiencies cited today This report was reviewed and signed by Owner, Moderage Shamin Perera. This notice of Site visit was provided to the licensee and must remain posted for 30 days. SUPERVISORS NAME: Daniel J Oquendo LICENSING EVALUATOR NAME: Nathan Garcia LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023 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: SHARMILA MONTESSORI HOUSE OF CHILDREN FACILITY NUMBER: 414004942 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/16/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/18/2023 Section Cited 101700.3 1 2 3 4 5 6 7101700.3 California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by:1 2 3 4 5 6 7The affected fixtures will be remediated and retested. The facility will update LPA for scheduled retest date and results will be forwarded to LPA for verification. 8 9 10 11 12 13 14Based on results received from the certified water samplers, the facility exceeded 5.4 ppb of lead in their water source. This pose a potential health, safety, or personal rights risk to persons in care.8 9 10 11 12 13 14The facility will notify LPA of the retest results by set due date. 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:Daniel J Oquendo LICENSING EVALUATOR NAME:Nathan Garcia LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023

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 November 16, 2023, Licensing Program Analyst (LPA) Garcia conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with owner Moderage Shamin Perera. LPA explained the purpose of the visits and was given a tour of the facility. Present in facility are 21 children, with 5 staff members. LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. The facility received the ALE report from the Vendor on October 7, 2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and barricaded and or made the affected fixture out of order. The affected fixtures are A(8), B(10), and C(13) parts per billion (ppb) of lead. Per director, fixture A and C are sinks located in the classrooms. Fixture B is garden hose used for watering plants or any outdoor water play. LPA also observed that the facility uses water services for food preparation and drinking. LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), sent in an email to the LPA. * See next page for deficiencies cited today This report was reviewed and signed by Owner, Moderage Shamin Perera. This notice of Site visit was provided to the licensee and must remain posted for 30 days. SUPERVISORS NAME: Daniel J Oquendo LICENSING EVALUATOR NAME: Nathan Garcia LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023 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: SHARMILA MONTESSORI HOUSE OF CHILDREN FACILITY NUMBER: 414004942 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/16/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/18/2023 Section Cited 101700.3 1 2 3 4 5 6 7101700.3 California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by:1 2 3 4 5 6 7The affected fixtures will be remediated and retested. The facility will update LPA for scheduled retest date and results will be forwarded to LPA for verification. 8 9 10 11 12 13 14Based on results received from the certified water samplers, the facility exceeded 5.4 ppb of lead in their water source. This pose a potential health, safety, or personal rights risk to persons in care.8 9 10 11 12 13 14The facility will notify LPA of the retest results by set due date. 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:Daniel J Oquendo LICENSING EVALUATOR NAME:Nathan Garcia LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023

Type B citation - potential risk if not corrected