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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801766
Report Date: 12/08/2022
Date Signed: 12/08/2022 12:54:10 PM


Document Has Been Signed on 12/08/2022 12:54 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:WILSON PRESCHOOLFACILITY NUMBER:
103801766
ADMINISTRATOR:LORI WELCHFACILITY TYPE:
850
ADDRESS:504 FALLERTELEPHONE:
(559) 524-6959
CITY:SANGERSTATE: CAZIP CODE:
93657
CAPACITY:90CENSUS: 0DATE:
12/08/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Lori WelchTIME COMPLETED:
01:20 PM
NARRATIVE
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On 12/8/2022 Licensing Program Analyst (LPA) Caroline Harris conducted an unannounced case management inspection. LPA met with Director, Lori Welch for the purpose of conducting a case management inspection, regarding a lead exceedance referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

Fresno Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from the LA testing report and self reported information for SUSD- Wilson # 103801766 impacted with an ALE of 7.25 ppb in (outlet A, elementary school kitchen sink used for food prep). This result indicates out of compliance over (ALE) 5.5 ppb. (See Plan of correction for further corrective action 809D). The outlet was temporarily made inoperable as the water was shut off to the faucet and the outlet was capped. The fixture has since been replaced and an in line filter was installed. The outlet will be resampled for an action level result of under 5.5 ppb for compliance with a Certified Sampler. The outlet is covered until it can be re tested. The kitchen has two other sinks that are being used.

Facility also posted results for parents to review Per PIN 21-21 CCP WD 101703 (b). In addition parents and guardians have been notified of the (ALE ) Per PIN 21-21 CCP WD 101704 (b)(3) threw a letter and information uploaded on their Remind App.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809 D). Mrs. Welch was provided a copy of appeal rights. An exit interview was conducted. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2022
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


Document Has Been Signed on 12/08/2022 12:54 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: WILSON PRESCHOOL
FACILITY NUMBER: 103801766

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/09/2023
Section Cited

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California Lead Action Level at Child Care Centers (a) California’s Action Level for lead in water at Child Care Centers is 5 ppb. (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. (c) If testing indicates an Action Level Exceedance at any water outlet, the water from that outlet is deemed not safe to drink and an immediate response pursuant to section 101704 shall be required.
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This requirement was not met evidence by: Based on record review provided by LA Testing indicating (ALE) of 7.25 ppb in outlet A in the elemntary school kitchen, used for food preparation. These results indicate out of compliance over (ALE) 5.5 ppb, which poses a potential health, safety or personal rights risk to persons in care.
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The facility has notified parents and guardians via a letter and posted (ALE) results at a reasonable location for Authorized Representatives to review. Information was also uploaded on their Remind App.

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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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2022
LIC809 (FAS) - (06/04)
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