334814630-5-22-2023-09-CC-SBRR-CS3RQA-20230522131312

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334814630
Report Date: 05/22/2023
Date Signed: 05/22/2023 01:13:20 PM

Document Has Been Signed on 05/22/2023 01:13 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	RUSD-EMERSON ELEMENTARY		FACILITY NUMBER:	334814630
ADMINISTRATOR:	NATANYA JOHNSON		FACILITY TYPE:	850
ADDRESS:	4660 OTTAWA AVENUE		TELEPHONE:	(951) 788-7462
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92507
CAPACITY:	24	CENSUS: 25	DATE:	05/22/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Director Patricia Tran and Program Specialist Luz Romero		TIME COMPLETED:	12:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Due to required lead testing requirements, Licensing Program Analyst (LPA), Susan Brewer conducted a Case Management inspection based on lead testing results received on the facility. LPA S.Brewer arrived at the facility unannounced, was greeted by Lead Teacher Juanita Cruz, and granted entry to tour the facility and took census. LPA took a census of 14 children in the AM class and 11 children in the PM class, supervised by 3 staff. Licensee Director Patricia Tran, arrived to join the inspection at 10:10 AM. Program Specialist Luz Romero, arrived at 10:55 AM and joined the inspection. The following was discussed regarding lead results received and measures taken for remediation of lead exceedances. During the inspection, LPA toured and obtained photos of the following water outlets identified with lead exceedances: Outlet B drinking fountain, resulted in 6.3 ppb, which is installed and located in the Preschool classroom 1. LPA observed and obtained photos of required signage posted at outlets for cessation of use. Facility implemented the following plan of action until formal remediation can be completed on water outlets by covering the drinking fountain with plastic to make inaccessible and placing the notice to staff, children and the public that the fountain for cessation of use. A purchase order has been submitted to complete repair and replacement of parts for outlet B. Once the outlet has been replaced, the facility will submit a request for retesting. LPA observed notification of lead results posted at the facility classrooms front entrance, above the sign-in desk. Photos also obtained of additional source for access to water: Facility has access to additional water resources through an outdoor water fountains and water dispenser, to use for consumption.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RUSD-EMERSON ELEMENTARY	FACILITY NUMBER: 334814630
	VISIT DATE: 05/22/2023

NARRATIVE

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Records show that the outdoor outlets identified as C, D and E, for use were tested and levels were below 5.5 ppb. However, the facility was unable to provide proof of lead testing on outlets located in facility kitchen, which were missing in the sampling of outlets used for water consumption and/or food preparation. The matter of lead testing for the facility kitchen was addressed during the annual inspection conducted, and the LPA issued a separate report on today's date.

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

Additionally, the following resources were discussed and provided from PIN 21-21-CCP dated July 28, 2021:
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:

(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 S. Brewer provided Program Specialist Luz Romero, 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) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/22/2023 01:13 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RUSD-EMERSON ELEMENTARY	FACILITY NUMBER: 334814630
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/22/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/22/2023 Section Cited CCR 101700.3(b)(1)	1 2 3 4 5 6 7	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:	1 2 3 4 5 6 7	Facility will implement corrective action pursuant to section CCR 101704 for immediate cessation of outlets testing with action level exceedance until it is replaced and retested pursuant to section CCR 101705 and returns a result at or below the Acton level.
	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 outlet B, with a level exceedance of 6.3 ppb, for a drinking fountain in classroom 1. This is a potential health and safety risk to persons in care.	8 9 10 11 12 13 14	Facility will notify CDSS with completion within 30 days.
	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) 782-4200
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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