SINAI 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 25Licensing Program Analyst (LPA) Janette Cruz, conducted an unannounced case management inspection and met with Ifat Kantorovitch, Director. LPA informed Director that purpose of visit is to discuss Lead Sampling Testing conducted on 11/05/2021. Census was taken, LPA observed 34 children with 10 staff supervising. LPA informed Director that the testing of water supply in Sites A & N indicated an Action Level Exceedance, hence, water from these two sites is deemed not safe to drink or be used for food preparation due to elevated levels of lead. Director provided LPA with water sampling report dated 12/03/2021 from Pace Analytical Environmental Sciences that indicated results on both sites A & N are above 5ppb. Director stated that she will have the sink on both sites fixed and have the water supply retested by a certified external water sampler within 30 days and before use. Director immediately made the affected water outlets with elevated levels of lead inaccessible for use. Director also stated that water from these two sites would also be turned off until it can be replaced or repaired. In addition, Director stated that the facility was not using the two affected water fountains due to COVID. Director stated that facility does not do any food preparation in the facility since they do not offer any food or snacks. Director stated that facility is using the faucets and water fountains inside the classrooms for drinking. Based on LPA's record review and observation, the following violation is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 3, Section 101238 (a) Buildings and Grounds. See attached 809D. Exit interview was completed and Appeal Rights were discussed with Ifat Kantorovich. A NOTICE OF SITE VISIT WAS ISSUED AND POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS. SUPERVISORS NAME: Diana Stephenson LICENSING EVALUATOR NAME: Janette Cruz LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022 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: SINAI NURSERY SCHOOL FACILITY NUMBER: 434408052 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/06/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/20/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7101238(a)Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by:1 2 3 4 5 6 7Licensee will submit a written plan of action by POC date 4/20/22 stating the affected water outlets will be repaired and retested within 30 days before use for drinking. Licensee will have bottled waters available on site. 8 9 10 11 12 13 14Based on observations, interview and record review, the CCC Lead Sampling report for the facility indicated that water from two outlet sites have elevated lead greater than 5ppb which poses a potential health and safety or Personal 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:Diana Stephenson LICENSING EVALUATOR NAME:Janette Cruz LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Janette Cruz, conducted an unannounced case management inspection and met with Ifat Kantorovitch, Director. LPA informed Director that purpose of visit is to discuss Lead Sampling Testing conducted on 11/05/2021. Census was taken, LPA observed 34 children with 10 staff supervising. LPA informed Director that the testing of water supply in Sites A & N indicated an Action Level Exceedance, hence, water from these two sites is deemed not safe to drink or be used for food preparation due to elevated levels of lead. Director provided LPA with water sampling report dated 12/03/2021 from Pace Analytical Environmental Sciences that indicated results on both sites A & N are above 5ppb. Director stated that she will have the sink on both sites fixed and have the water supply retested by a certified external water sampler within 30 days and before use. Director immediately made the affected water outlets with elevated levels of lead inaccessible for use. Director also stated that water from these two sites would also be turned off until it can be replaced or repaired. In addition, Director stated that the facility was not using the two affected water fountains due to COVID. Director stated that facility does not do any food preparation in the facility since they do not offer any food or snacks. Director stated that facility is using the faucets and water fountains inside the classrooms for drinking. Based on LPA's record review and observation, the following violation is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 3, Section 101238 (a) Buildings and Grounds. See attached 809D. Exit interview was completed and Appeal Rights were discussed with Ifat Kantorovich. A NOTICE OF SITE VISIT WAS ISSUED AND POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS. SUPERVISORS NAME: Diana Stephenson LICENSING EVALUATOR NAME: Janette Cruz LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022 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: SINAI NURSERY SCHOOL FACILITY NUMBER: 434408052 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/06/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/20/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7101238(a)Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by:1 2 3 4 5 6 7Licensee will submit a written plan of action by POC date 4/20/22 stating the affected water outlets will be repaired and retested within 30 days before use for drinking. Licensee will have bottled waters available on site. 8 9 10 11 12 13 14Based on observations, interview and record review, the CCC Lead Sampling report for the facility indicated that water from two outlet sites have elevated lead greater than 5ppb which poses a potential health and safety or Personal 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:Diana Stephenson LICENSING EVALUATOR NAME:Janette Cruz LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022

Type B citation - potential risk if not corrected