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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808610
Report Date: 02/09/2023
Date Signed: 02/09/2023 03:59:23 PM


Document Has Been Signed on 02/09/2023 03:59 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:PENNINGTON'S LITTLE FRIENDSFACILITY NUMBER:
243808610
ADMINISTRATOR:PENNINGTON, MARLENEFACILITY TYPE:
850
ADDRESS:515 STONEWOOD DRIVETELEPHONE:
(209) 826-2818
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:30CENSUS: 37DATE:
02/09/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Maria BorbaTIME COMPLETED:
04:15 PM
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On 02/09/2023 Licensing Program Analysts (LPAs) Martha DeHaro and Ka Vang conducted an unannounced case management inspection. LPAs met with Director Maria Borba and explained the purpose of the case management inspection was to follow up with the lead exceedance referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb).

During the inspection, LPAs obtained a copy of the lead testing report and facility sketch that was conducted by BSK Associates on 11/11/2020. Per the report, the kitchen sink of the facility was tested and the result indicated 5.0 per billion (ppb). Per Maria Borba, the facility is using the kitchen sink for the purpose of cooking and preparing food only. The facility provides portable bottled water for the children, staff and visitors. LPAs did not observe any other types of drinking fountains or faucets inside or outside of the facility. LPAs observed the facility has three restrooms with three sinks for the purpose of hand washing only. Per the report and LPAs observation, the facility is within compliance with the lead exceedance.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited during today's inspection. 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: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Martha DeHaroTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023
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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