ST. JAMES EPISCOPAL CHURCH NURSERY 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 March 17, 2023, at 1:30 PM, Licensing Program Analyst (LPA) April Cowan conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with the assistant director, Olivia Tsang. The purpose of the inspection was explained. Present in facility is assistant director, 3 staff, and 12 children in care. 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 assistant 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 12/9/22. 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. The facility took action to repair and replace the fixture. Per assistant director, the certified plumber visited on 3/7/23 to replace faucet A. Once the faucet is installed, the facility will be flushing the fixture as instructed by the certified water samplers. The facility will be scheduling a retest with the certified water samplers three weeks after the flush has been done. The facility asked the children to bring their own water from home and the bottles are replenished by using filtered water, as needed. The facility is planning to utilize the affected fixtures once they are repaired. Facility is currently waiting for a retesting of the faucet. * See next page for deficiency cited today SUPERVISORS NAME: Garfield Leung LICENSING EVALUATOR NAME: April Cowan LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023 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: ST. JAMES EPISCOPAL CHURCH NURSERY SCHOOL FACILITY NUMBER: 380500619 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/17/2023 Section Cited 101700.3(b)(1) 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 7Director will provide the new test results to LPA no later than 4/17/23. 8 9 10 11 12 13 14Based on results received from the certified water samplers, the facility exceeded 5.5 ppb of lead in their water source. Once received, the facility took immediate and proper actions to remediate the fixtures. This 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:Garfield Leung LICENSING EVALUATOR NAME:April Cowan LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023

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 March 17, 2023, at 1:30 PM, Licensing Program Analyst (LPA) April Cowan conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with the assistant director, Olivia Tsang. The purpose of the inspection was explained. Present in facility is assistant director, 3 staff, and 12 children in care. 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 assistant 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 12/9/22. 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. The facility took action to repair and replace the fixture. Per assistant director, the certified plumber visited on 3/7/23 to replace faucet A. Once the faucet is installed, the facility will be flushing the fixture as instructed by the certified water samplers. The facility will be scheduling a retest with the certified water samplers three weeks after the flush has been done. The facility asked the children to bring their own water from home and the bottles are replenished by using filtered water, as needed. The facility is planning to utilize the affected fixtures once they are repaired. Facility is currently waiting for a retesting of the faucet. * See next page for deficiency cited today SUPERVISORS NAME: Garfield Leung LICENSING EVALUATOR NAME: April Cowan LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023 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: ST. JAMES EPISCOPAL CHURCH NURSERY SCHOOL FACILITY NUMBER: 380500619 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/17/2023 Section Cited 101700.3(b)(1) 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 7Director will provide the new test results to LPA no later than 4/17/23. 8 9 10 11 12 13 14Based on results received from the certified water samplers, the facility exceeded 5.5 ppb of lead in their water source. Once received, the facility took immediate and proper actions to remediate the fixtures. This 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:Garfield Leung LICENSING EVALUATOR NAME:April Cowan LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023

Type B citation - potential risk if not corrected