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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163808397
Report Date: 03/03/2023
Date Signed: 03/03/2023 03:24:26 PM


Document Has Been Signed on 03/03/2023 03:24 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:LEMOORE GENERATION CENTERFACILITY NUMBER:
163808397
ADMINISTRATOR:ENRIQUEZ, CARLAFACILITY TYPE:
850
ADDRESS:1075 BLAKE STREETTELEPHONE:
(559) 925-1502
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY:76CENSUS: 12DATE:
03/03/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Gloria VelezTIME COMPLETED:
03:00 PM
NARRATIVE
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On 03/03/23 Licensing Program Analyst (LPA) Daniel Alvarez conducted an unannounced case management inspection. LPA Alvarez met with Assistant Site Supervisor Gloria Velez 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 Associates, Inc. and discussed with Assistant Site Supervisor Gloria Velez, it has been determined that there is an exceedance to outlets (C) and (D) in the facility. LPA Alvarez inspected outlet (D) it was observed to be a indoor drinking faucet in room 3 that was impacted with 7ppb (ALE) of lead. LPA Alvarez also inspected outlet (D) it was also observed to be a indoor drinking faucet in room 4 that was impacted with 7.6ppb (ALE) of lead.

Facility has made both drinking faucets inoperable to preschool by placing a "Do Not Use" sign on the faucets, and turning off the water until faucets have been replaced and retested. Assistant Site Supervisor Gloria Velez stated that all water for drinking is now being supplied by water dispenser containers to each classroom.

(See plan of correction for further corrective action 809D). 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, 809D). Assistant Site Supervisor Gloria Velez 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) 650-7890
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
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 03/03/2023 03:24 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: LEMOORE GENERATION CENTER
FACILITY NUMBER: 163808397

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/07/2023
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 Site Supervisor affected outlet has been made inoperable until replacement outlet can installed. Facility will conduct daily flushing for three weeks and will have a second water lead sampling test and notify Community Care Licensing (CCL) of results.
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Based on record review, two 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 has notified all parents/authorized representatives of ALE, and of any corrective action already taken at the facility

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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) 650-7890
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
LIC809 (FAS) - (06/04)
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