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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334810747
Report Date: 10/31/2022
Date Signed: 10/31/2022 01:14:14 PM


Document Has Been Signed on 10/31/2022 01:14 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:WOODCREST MONTESSORI EDUCATION CENTERFACILITY NUMBER:
334810747
ADMINISTRATOR:DIANE MARTINEZFACILITY TYPE:
850
ADDRESS:16191 WASHINGTON STREETTELEPHONE:
(951) 789-9319
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:66CENSUS: 43DATE:
10/31/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Elizabeth Bunker, Executive Director/OwnerTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Kay Turner arrived at the facility to conduct a case management visit regarding the lead testing. LPA met with the Executive Director/Owner, Elizabeth Bunker, and explained the purpose for today's visit. LPA toured the center and a census was taken.

On 08/27/2022, lead testing was completed of the water sources at the facility. The drinking fountain located outside in the front of the facility tested at the exceedance level of 5.5. Since the lead testing, the water to the drinking fountain has been turned off. The facility has other faucet sources for water, which include the following: 2 drinking fountains in Room 1 and 3 drinking fountains located on the playground outside in the back of the facility. Room 2 does not have a drinking fountain. The children in Room 2 supply their own water. The facility's plan of correction is to replace the drinking fountain head and retest. The facility completed the Continued Compliance form and is awaiting the approval to replace the drinking fountain head. Upon completion, the drinking fountain will be retested. The aforementioned resulted in a deficiency, as the documented lead levels exceeded 5.5 ppb and is above the level of exceedance per the Lead Testing Written Directives. Please see 809D for deficiency.

Exit interview conducted and report was reviewed with the Executive Director/Owner, Elizabeth Bunker.

A copy of this report was provided to the Program Director and a Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Karrene TurnerTELEPHONE: 951-970-1161
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2022
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 10/31/2022 01:14 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: WOODCREST MONTESSORI EDUCATION CENTER
FACILITY NUMBER: 334810747

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/31/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/14/2022
Section Cited

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(b)(1), A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. 
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Per the lead sample report completed on 08/27/2022, the drinking fountain located in the front of the facility lead test results were 5.5 UG/L, at the action level of exceedance.
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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: Aaron RossTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Karrene TurnerTELEPHONE: 951-970-1161
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2022
LIC809 (FAS) - (06/04)
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