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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010206141
Report Date: 05/16/2023
Date Signed: 05/16/2023 02:34:26 PM


Document Has Been Signed on 05/16/2023 02:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:MERRITT COLLEGE CHILDREN'S CENTERFACILITY NUMBER:
010206141
ADMINISTRATOR:ERICA HARRELLFACILITY TYPE:
850
ADDRESS:12500 CAMPUS DRIVETELEPHONE:
(510) 436-2436
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:98CENSUS: 14DATE:
05/16/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Irma LastraTIME COMPLETED:
02:40 PM
NARRATIVE
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On 5/16/23 at 11:45am, Licensing Program Manager (LPM) Loretta Dyson and Licensing Program Analyst (LPA) Lisa Dyer arrived at the facility to conduct an unannounced case management inspection to follow up on results received regarding lead exceedance. LPM and LPA met with Irma Lastra. There were 14 children and 3 additional staff also present.

The facility completed the required lead testing of water outlets used to prepare food, or provide drinking water, for children and two outlets were found to be in exceedance of the Action Level of 5 ppb. The facility took immediate action and made the two outlets inaccessible to children while they were being repaired. The facility completed and submitted all required documents to Licensing, and notified all families of the test results with a letter. LPM and LPA inspected the two outlets and verified that they have been made inaccessible, and signs have been placed to advise not to use the outlets. The facility understands that they are unable to use the two outlets until they receive the test results, and the Action Level is 5 ppb or below.

See LIC 809D for a deficiency being cited today. No other deficiencies are being cited today. An exit interview was conducted with Irma Lastra, and a copy of this report, Notice of Site Visit, and appeal rights were emailed to the facility. The facility was reminded to have the Notice of Site Visit posted for 30 days.

SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/16/2023 02:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: MERRITT COLLEGE CHILDREN'S CENTER
FACILITY NUMBER: 010206141

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2023
Section Cited
CCR
101700.3(b)(1)

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101700.3 California Lead Action Level at Child Care Centers (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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The facility immediately made the two outlets inaccessible to children while repairs were being completed. The facility is working on repairing the outlets, and will submit proof of this by 5/31/23.
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This requirement has not been met as evidenced by the lead testing results received, indicating that two outlets in the facility had results in exceedance of the 5 ppb Action Level. This poses a potential risk to the children in care.
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The facility will submit the test results once the outlets are retested, and understands not to use the outlets until the Action Level is determined to be 5 ppb or below.

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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: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: 510-695-0243
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2023
LIC809 (FAS) - (06/04)
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