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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163801067
Report Date: 03/07/2023
Date Signed: 03/07/2023 10:36:29 AM


Document Has Been Signed on 03/07/2023 10:36 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:PRESTON J. GREEN, SR., LEARNING CENTERFACILITY NUMBER:
163801067
ADMINISTRATOR:SIBRIAN, BARBARAFACILITY TYPE:
850
ADDRESS:11411 SOUTH ELEVENTH AVENUETELEPHONE:
(559) 582-5184
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:170CENSUS: 133DATE:
03/07/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Barbara SibrianTIME COMPLETED:
10:45 AM
NARRATIVE
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On 03/07/2023, Licensing Program Analyst (LPA) Candis Rodriguez conducted an unannounced case management inspection. LPA met with Site Supervisor Barbara Sibrian who accompanied LPA on a tour of the facility, and a census was taken. The purpose of today's inspection is to address 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 South Regional Office received notification of water lead exceedance at the facility resulting from a water lead sampling test collected on 01/31/2023. Records were reviewed from Moore Twining and discussed with Site Supervisor. It has been determined that there is an exceedance to outlets B, D, F, and I in the facility. LPA inspected outlet B and it was observed to be a drinking faucet in Room 1 that was impacted with 19ppb (ALE) of lead. LPA inspected outlet D and it was observed to be a drinking faucet in Room 3 that was impacted with 8.8ppb (ALE) of lead. LPA inspected outlet F and it was observed to be a drinking faucet in Room 5 that was impacted with 6.6ppb (ALE) of lead. LPA inspected outlet I and it was observed to be an exterior faucet that was impacted with 26ppb (ALE) of lead.

Facility has made the faucets inoperable by covering with plastic and labeling not in use until replaced. Facility is providing portable bottled/water jugs for drinking water. LPA observed that all water for food prep is being used from faucet A in the facility Kitchen which tested at a level of 1.0ppb.

(See plan of correction for further corrective action, LIC 809-D). Facility has already notified all the authorized representatives of this corrective action in English and Spanish.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809-D). Site Supervisor was provided a copy of the appeal rights.
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: Susie FanningTELEPHONE: (559) 341-4117
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
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 03/07/2023 10:36 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: PRESTON J. GREEN, SR., LEARNING CENTER
FACILITY NUMBER: 163801067

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/11/2023
Section Cited

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California 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 ... (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE). This requirement was not met as evidenced by
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Per Director Evelyn Solorio, the affected outlets will be replaced and retested. Facility will provide water lead sampling retesting and notify Community Care Licensing (CCL) of results. The four drinking fountains have been covered and labeled not in use.
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Based on record review, four outlets at the facility contained lead exceedance greater than 5.5 ppb. This poses a potential health, safety or personal rights risk to persons in care.
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Facility notified all authorized representatives in English and Spanish of lead testing results. The results have also been posted at the facility where authorized representatives can view them. Facility is providing alternative drinking water in affected classrooms with portable water jugs, indoor and outdoor.

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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: Susie FanningTELEPHONE: (559) 341-4117
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
LIC809 (FAS) - (06/04)
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