300600189-8-23-2022-06-CC-MMAK-CHKRN4-20220823130943

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300600189
Report Date: 08/23/2022
Date Signed: 08/23/2022 01:10:10 PM

Document Has Been Signed on 08/23/2022 01:10 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	COMMUNITY PRESBYTERIAN PRESCHOOL & KINDERGARTEN		FACILITY NUMBER:	300600189
ADMINISTRATOR:	TREEMARCKI-BECK, TERRI		FACILITY TYPE:	850
ADDRESS:	32202 DEL OBISPO		TELEPHONE:	(949) 493-9141
CITY:	SAN JUAN CAPISTRANO	STATE: CA	ZIP CODE:	92675
CAPACITY:	100	CENSUS: 49	DATE:	08/23/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Director		TIME COMPLETED:	01:30 PM

NARRATIVE

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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an unannounced Case Management Inspection to discuss the Lead Sampling testing conducted 06/23/22. The Covid-19 Emergency Response questionnaire was answered by director, Terri Treemarcki-Beck. LPA and the director toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. 5 classrooms (A, B, C, D, and E) were inspected. Classrooms D and E are located on the first level and the rest of the classrooms are located on a higher level of this building. The preschool is located on a Church ground. There were a total of 49 preschool children with 7 staff in the classrooms and on the playground
A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA met with director, Terri Treemarcki-Beck and ensured the Lead Sample Report is posted. Director was advised on 8/16/22 the Lead Sample Report was to be posted. LPA confirmed the Director posted the Sample Report.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test.

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: COMMUNITY PRESBYTERIAN PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 300600189
	VISIT DATE: 08/23/2022

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Community Care Licensing was notified that lead water testing conducted at the facility on 6/23/2022 failed allowable limit for lead. The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedance (ALE).

Instructions for required lead testing are outlined in PIN 21-21-CCP. This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations.

Director, Terri Treemarcki-Beck stated one of the outlets with high lead level was located inside classroom B marked as source "C" as drinking water fountain which is installed on a sink. LPA observed the water fountain inside the classroom B marked as "C" on the map of the sink was made inoperable by means of turning off the drinking fountain and a fabric covered the drinking fountain no to be visible. "Director stated the facility utilizes the sink faucet for hand washing only. The director stated they were not using the water fountain since COVID hit in 2019.

Based on LPA's record reviews, the following violation was observed and is being cited in accordance with
California Code of Regulations Title 22, Division 12, Chapter 3, Section 101238(a) Buildings and Grounds is being cited on the attached LIC 809D.

Exit interview conducted and report was reviewed with the Director, Terri Treemarcki-Beck.
A notice of site visit was given and must remain posted for 30 days.

Appeal Rights and deficiency was discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

End of report.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/23/2022 01:10 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: COMMUNITY PRESBYTERIAN PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 300600189
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/23/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/26/2022 Section Cited	1 2 3 4 5 6 7	101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on facility Lead sampling tests it was discovered that outlet (drinking water) marked as "C" on report in room B had high level of lead. This poses a potential risk to the health of children in care.	8 9 10 11 12 13 14	fountain since COVID hit in 2019. Director agreed to provide documentation that they will use the faucet of the sink for hand washing only and the drinking fountain is inaccessible. The director stated they would remove the fountain for the future plan.
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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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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