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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808761
Report Date: 09/13/2022
Date Signed: 09/13/2022 03:07:34 PM


Document Has Been Signed on 09/13/2022 03:07 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:CCCDS-FELIX TORRES CDC 1FACILITY NUMBER:
243808761
ADMINISTRATOR:PEREZ-ORDAZ, TANIAFACILITY TYPE:
850
ADDRESS:921 N. PLAINSBURG ROADTELEPHONE:
(209) 581-9000
CITY:PLANADASTATE: CAZIP CODE:
95365
CAPACITY:35CENSUS: 11DATE:
09/13/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Claudia VillatoroTIME COMPLETED:
03:20 PM
NARRATIVE
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On 09/13/22 Licensing Program Analyst (LPA) Araceli Gibson conducted an unannounced case management inspection. LPA Gibson met with Claudia Villatoro, Nutrition Services Coordinator and Tania Perez Ordaz, Site Supervisor. Purpose of today's inspection is to conduct a case management inspection, and to notify them there has been 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 Pace Analytical with Claudia Villatoro, Nutrition Services Coordinator and Tania Perez-Ordaz, Site Supervisor met and discussed impacted outlet despite facility being built in 2012 ALE is still an issue in regards to Health and safety to children in care. LPA Gibson inspected outlet (N) in an outdoor drinking fountain (2 of 2) that was impacted with 8.8 ppb (ALE) of lead. Site Supervisor has disconnected water outlet (N) until repairs can be made. Potable water is available to preschool children. An IGLOO with water from a potable from this source and cups are available to preschool children during day care hours. (See Plan of correction for further corrective action 809D). Site Supervisor has notified authorized representatives of this corrective action in both languages English and Spanish.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809 D). Claudia and Tania were provided a copy of appeal rights. An exit interview was conducted with both.

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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2022
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 09/13/2022 03:07 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: CCCDS-FELIX TORRES CDC 1
FACILITY NUMBER: 243808761

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/13/2022
Section Cited

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 101700.3 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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This requirement was not met evidence by: Based on record review provided by PACE Analytica a result of (ALE) of 8.8 for outlet N. which is out of compliance over the allowable ALE 5.5 ppb. 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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2022
LIC809 (FAS) - (06/04)
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