<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407476
Report Date: 03/06/2024
Date Signed: 03/06/2024 01:01:29 PM


Document Has Been Signed on 03/06/2024 01:01 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:BLACKHAWK MONTESSORIFACILITY NUMBER:
073407476
ADMINISTRATOR:BARI, NAVEEDA & PATEL, N.FACILITY TYPE:
850
ADDRESS:3380 BLACKHAWK PLAZA CIR,ST112TELEPHONE:
(925) 575-7212
CITY:DANVILLESTATE: CAZIP CODE:
94506
CAPACITY:144CENSUS: 14DATE:
03/06/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Naureen Patel/Naveeda BariTIME COMPLETED:
01:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 3/6/24 at 11:15am Licensing Program Analyst (LPA) Ashley Akinleye arrived at BlackHawk Montessori Preschool Center for an unannounced case management- lead testing inspection. LPAwas met by directors Naveeda Bari and Naureen Patel and was granted access to the facility.

During inspection LPA discovered that lead testing was completed in May of 2023. According to Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 lead testing should have been completed before Jan 1, 2023:

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA verified that lead testing results did not display any exceedances. However, a Type B citation is being cited today due to testing not being completed before January 1, 2023.

Exit interview conducted with directors Naveeda Bari and Naureen Patel. Appeal rights were provided and a Notice of Site Visit to post for 30 days.

SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley AkinleyeTELEPHONE: (510) 926-9152
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
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


Document Has Been Signed on 03/06/2024 01:01 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: BLACKHAWK MONTESSORI
FACILITY NUMBER: 073407476

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2024
Section Cited
HSC
1597.16(a)(1)

1
2
3
4
5
6
7
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.
1
2
3
4
5
6
7
Facility will test for lead exposure in time per regulation.
8
9
10
11
12
13
14
This requirement is not met as evidenced by:
Based upon record review and interview the facility failed to complete lead testing before Jan 1, 2023. Lead testing was completed May of 2023.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
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: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley AkinleyeTELEPHONE: (510) 926-9152
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2