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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070209620
Report Date: 05/24/2023
Date Signed: 05/24/2023 04:28:09 PM

Document Has Been Signed on 05/24/2023 04:28 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:CITY OF EL CERRITO COMM. SVCS. - HARDING PARKFACILITY NUMBER:
070209620
ADMINISTRATOR:EDEN O'BRIEN BRENNERFACILITY TYPE:
840
ADDRESS:7115 C STREETTELEPHONE:
(510) 559-7003
CITY:EL CERRITOSTATE: CAZIP CODE:
94530
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: DATE:
05/24/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:TIME COMPLETED:
04:45 PM
NARRATIVE
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On 05/24/2023 at 3:45PM Licensing Program Analyst (LPA) Nyeesha Blount conducted a unannounced Case management for Lead Testing/ exceedance at City of El Cerrito Comm Svcs Harding Park. LPA met with Director Banuelos, Lila and explained the purpose of today's inspection.

LPA toured the facility for a health and safety check. The sink fountain in classroom B exceeded the acceptable amount of lead allowed in a child care center. The director stated that facility has used the sinks since facility opened in classroom A & B and have been replaced.

The following deficiency was observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the director Banuelos, Lila. ..
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
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 05/24/2023 04:28 PM - It Cannot Be Edited


Created By: Nyeesha Blount On 05/24/2023 at 04:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CITY OF EL CERRITO COMM. SVCS. - HARDING PARK
FACILITY NUMBER: 070209620

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2023
Section Cited

101700.3

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Licensee shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.
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The facility has replaced both sink fountains in classroom A & B. No plan of Correction is needed.
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Based on record review the licensee did not comply with the section cited above as there was a sink fountain in classroom B had a lead exceedance, which poses a potential Health and Safety risk to persons in care.
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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:Mayla Mendoza
LICENSING EVALUATOR NAME:Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2023


LIC809 (FAS) - (06/04)
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