330908033-1-13-2023-09-CC-ASHA-CN2V4E-20230113150612

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 330908033
Report Date: 01/13/2023
Date Signed: 01/13/2023 03:08:17 PM

Document Has Been Signed on 01/13/2023 03:08 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	PSUSD - CIELO VISTA COMMUNITY CHILD CARE CENTER		FACILITY NUMBER:	330908033
ADMINISTRATOR:	KIMBERLY PORTER		FACILITY TYPE:	850
ADDRESS:	4150 E. SUNNY DUNES ROAD		TELEPHONE:	(760) 416-8257
CITY:	PALM SPRINGS	STATE: CA	ZIP CODE:	92264
CAPACITY:	95	CENSUS: 21	DATE:	01/13/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	01:46 PM
MET WITH:	Linda Rodriguez		TIME COMPLETED:	03:20 PM

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Due to required lead testing requirements, Licensing Program Analyst (LPAs), Aman Sharma and Laura Mejorado conducted a Case Management inspection based on lead testing results received on the facility. LPAs toured the facility, took census and met with administrator Linda Rodriguez to further discuss the lead results received and measures taken for remediation of lead exceedances.

During the inspection, LPAs toured and obtained photos of the following water outlet identified with lead exceedances: Outlet I (36.50 ppb) which is located in the back room . LPAs observed and obtained photos of required signage posted at outlets for cessation of use.

Facility has already implemented the following plan of action: The water outlet that tested with high levels of lead is not used by the facility. The sink is in the back room which is an off-limit area of the facility and only utilized by the school's janitorial staff. Facility uses filtered water in cups for water consumption. LPAs observed notification of lead results posted at the facility entry- front doors.

Due to facility water outlets testing above approved lead levels, a deficiency has been cited. See LIC809D.

Additionally, the following resources were discussed and provided from PIN 21-21.1- CCP dated December 28, 2022:

101700.6 Grant Funding for Qualifying Child care Centers

(a) Senate Bill 862, Chapter 449, Statutes of 2018 allocated $5 Million to the State Water Resources Control Board for testing and remediation of lead in the drinking water of Child Care Centers based on the following criteria:

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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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Document Has Been Signed on 01/13/2023 03:08 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PSUSD - CIELO VISTA COMMUNITY CHILD CARE CENTER	FACILITY NUMBER: 330908033
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/13/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/13/2023 Section Cited	1 2 3 4 5 6 7	California Lead Action Level at Child Care Centers 101700.3 (b)(1): A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidence by: Facility will implement corrective action pursuant to section CCR 101704	1 2 3 4 5 6 7	Facility's outlet "I" is located in the back room which is an 'off-limit' area and not utilized for water consumption or food preparation by facility staff. LPA's were able to confirm this during today's inspection.
	8 9 10 11 12 13 14	Based on records review of required lead testing, the facility had lead values of 5.5 or above on water outlets: Outlet I (36.50 ppb).This is a potential health and safety risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PSUSD - CIELO VISTA COMMUNITY CHILD CARE CENTER	FACILITY NUMBER: 330908033
	VISIT DATE: 01/13/2023

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(1) Those that serve children zero to five years of age, with the highest priority for Child Care Centers that provide care for children zero to three years of age.

(2) Those that have 50 percent or more of their registered children who receive subsidized care.

(3) Those that operate only one facility.

(b) To determine a Child Care Center’s eligibility for possible funding the Department will provide access to a link to an online eligibility form located on the Department’s website and on Sacramento State’s Office of Water Programs website.

(1) A Child Care Center interested in financial assistance shall complete the eligibility form, which shall include instructions for completing and returning it, prior to receiving any grant funding for which it may qualify. To determine a Child Care Center’s eligibility for possible funding, the provider will need to complete an online eligibility form available at Office of Water Programs’ website.

An exit interview was conducted, and appeal rights discussed. LPA provided Director Linda Rodriguez with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

LIC809 (FAS) - (06/04)

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