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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 240406429
Report Date: 12/14/2022
Date Signed: 12/14/2022 01:56:50 PM


Document Has Been Signed on 12/14/2022 01:56 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:LIVINGSTON CHILD DEVELOPMENT CENTERFACILITY NUMBER:
240406429
ADMINISTRATOR:GREWAL, RAJVINDERFACILITY TYPE:
850
ADDRESS:848 PRUSSO STREETTELEPHONE:
(209) 394-5440
CITY:LIVINGSTONSTATE: CAZIP CODE:
95334
CAPACITY:72CENSUS: 13DATE:
12/14/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Manisha Khosla - CoordinatorTIME COMPLETED:
02:00 PM
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On 12/14/22 Licensing Program Analyst (LPA) Joseph Pacheco conducted an unannounced case management inspection. LPA met with Coordinator, Manisha Khosla 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 Environmental Laboratory Accreditation Program (ELAP) report and self-reported information for Livingston Child Development Center License # 240406429 impacted with an ALE of 7.1 ppb in outlet H Community Room. These results indicate out of compliance over (ALE) 5.5 ppb. During today’s inspection LPA observed that Outlet H Community Room has been removed. LPA observed that facility is still able to provide water to the Community Room through Outlet G. This outlet has been tested and is in compliance.

Facility is providing water to the preschool children by means of a third party water delivery service. Fresh potable water is available to preschool children, visitors and staff during hours of operation. Director stated parents have been notified of the ALE Per PIN 21-21 CCP WD 101704(b)(3). Facility will also post results for parents to review Per PIN 21-21 CCP WD 101703(b).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D). Coordinator was provided a copy of their 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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022
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 12/14/2022 01:56 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: LIVINGSTON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 240406429

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/14/2022
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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Outlet H Community Room fixture was removed and the line was permanently capped ceasing use on 12/5/22. Authorized representatives were notified on 12/5/22. Deficiency cleared.
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This requirement was not met as evidenced by based on ELAP report provided by Licensee indicating an ALE of 7.1 ppb in outlet H Community Room. These results indicate an exceedance over ALE 5.5 ppb, which is out of compliance. This poses a potential health, safety or personal rights risk to persons in care.
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022
LIC809 (FAS) - (06/04)
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