HOPE LUTHERAN PRESCHOOL

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 November 7, 2023, Licensing Program Analysts (LPAs) Luis Gomez and Man Tso met with director, Tracy Siri. Purpose of inspection was explained and was for an unannounced, case management inspection to cite for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. Present in facility was director and two staff supervising 11 children. LPAs inspected facility for health and safety hazards. 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 July 19, 2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. Facility was proactive in getting facility faucets retested and barricaded, putting fixture out of order. The affected fixture, fixture C, tested (5.6). The affected fixture C (drinking fountain) was retested on December 15, 2022, with a reading of 5.1ppb. Per the written directives in the PIN 21-21.1-CCP, facility will be cited for the action level exceedance of the fixture. LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), have been sent in an email to the LPA. * See next page for deficiencies cited today This report was reviewed and signed by Director, Tracy Siri. This notice of Site visit was provided to the licensee and must remain posted for 30 days. SUPERVISORS NAME: Ali Zebila LICENSING EVALUATOR NAME: Man Tso LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2023 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: HOPE LUTHERAN PRESCHOOL FACILITY NUMBER: 410500322 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/07/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 11/21/2023 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 facility was retested the affected fixture on 12/15/22. It reads 5.1ppb which is lowered than the Action Level Exceedance. Deficiency has been cleared. 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 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:Ali Zebila LICENSING EVALUATOR NAME:Man Tso LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2023

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 7, 2023, Licensing Program Analysts (LPAs) Luis Gomez and Man Tso met with director, Tracy Siri. Purpose of inspection was explained and was for an unannounced, case management inspection to cite for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. Present in facility was director and two staff supervising 11 children. LPAs inspected facility for health and safety hazards. 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 July 19, 2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. Facility was proactive in getting facility faucets retested and barricaded, putting fixture out of order. The affected fixture, fixture C, tested (5.6). The affected fixture C (drinking fountain) was retested on December 15, 2022, with a reading of 5.1ppb. Per the written directives in the PIN 21-21.1-CCP, facility will be cited for the action level exceedance of the fixture. LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), have been sent in an email to the LPA. * See next page for deficiencies cited today This report was reviewed and signed by Director, Tracy Siri. This notice of Site visit was provided to the licensee and must remain posted for 30 days. SUPERVISORS NAME: Ali Zebila LICENSING EVALUATOR NAME: Man Tso LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2023 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: HOPE LUTHERAN PRESCHOOL FACILITY NUMBER: 410500322 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/07/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 11/21/2023 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 facility was retested the affected fixture on 12/15/22. It reads 5.1ppb which is lowered than the Action Level Exceedance. Deficiency has been cleared. 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 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:Ali Zebila LICENSING EVALUATOR NAME:Man Tso LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2023