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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808405
Report Date: 01/12/2023
Date Signed: 01/12/2023 09:38:28 AM


Document Has Been Signed on 01/12/2023 09:38 AM - 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:COPPER HILLS PRESCHOOL-CUSDFACILITY NUMBER:
103808405
ADMINISTRATOR:LOGAN, TARAFACILITY TYPE:
850
ADDRESS:1881 E. PLYMOUTHTELEPHONE:
(559) 327-9186
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:40CENSUS: 21DATE:
01/12/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Lauren GarciaTIME COMPLETED:
09:45 AM
NARRATIVE
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On 1/12/23 Licensing Program Analysts (LPAs) Caroline Harris and Martha DeHaro conducted an unannounced case management inspection. LPAs met with Teacher/Director, Lauren Garcia. The purpose of today's inspection is to discuss the lead exceedance, referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

The Fresno Regional Office, Community Care Licensing, received notification of water lead exceedance at the facility resulting from a recent water lead sampling testing. Records were reviewed from LA Testing, and LPAs inspected the drinking fountain bubbler outlet in the preschool room 16 ID B (7.89 ppb). LPAs observed the drinking fountain bubbler to have the water shut off. Mrs. Garcia reported that a maintenance request was made to permanently remove the bubbler and cap the outlet. IGLOO's with water are available in each classroom, as an alternative water sources for drinking. Parents or authorized representatives were notified of the lead testing results and the lead testing results were also posted for parents to view.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D). An exit interview was conducted with Lauren Garcia and she was provided a copy of this report, along with appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was 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: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023
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


Document Has Been Signed on 01/12/2023 09:38 AM - 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: COPPER HILLS PRESCHOOL-CUSD
FACILITY NUMBER: 103808405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/13/2023
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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A maintenance request was made to permanently remove the bubbler and cap the outlet. Teacher agrees to sumbit evidence of the removal of the bubbler and capping being completed by 30 days POC due date 02/13/23.
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This requirement was not met evidence by: Based on record review provided by licensee indicating (ALE) of 7.89 ppb in outlet B in Room 16. 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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Parents and guardians were notified and posted (ALE) results at a reasonable location for Authorized Representatives to review.

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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: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2