364818441-4-28-2023-09-CC-ASHA-CRBNXL-20230428105119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364818441
Report Date: 04/28/2023
Date Signed: 04/28/2023 10:51:29 AM

Document Has Been Signed on 04/28/2023 10:51 AM - 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:	PSD/FONTANA CITRUS HEAD START		FACILITY NUMBER:	364818441
ADMINISTRATOR:	ALONDRA LADISON		FACILITY TYPE:	850
ADDRESS:	9315 CITRUS AVENUE		TELEPHONE:	(909) 428-8496
CITY:	FONTANA	STATE: CA	ZIP CODE:	92335
CAPACITY:	140	CENSUS: 19	DATE:	04/28/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Alondra Ladison		TIME COMPLETED:	11:05 AM

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Due to required lead testing requirements, Licensing Program Analysts (LPAs) Aman Sharma and Justin Giese conducted a Case Management inspection based on lead testing results received from the facility. LPAs toured the facility, took census, and met with site supervisor Alondra Ladison, to further discuss lead results received and measures taken for remediation of lead exceedances.

During the inspection, LPAs toured the site and obtained photos of the following water outlets identified with lead exceedances: Outlet B (8.8 ppb) which was identified as facility kitchen prep sink and outlet I30 (ppb 6.2) identified as an outdoor drinking fountain.

LPA observed and obtained photos of required documents posted at the outlets for cessation of use.

Facility implemented the following plan of action: Facility is utilizing portable sinks which pump bottled water from the spouts for drinking water. LPA verified their functionality and observed adequate storage of 5 gallon water bottles. LPAs observed that outlet B was immediately closed off, flushed and replaced with a new sink. Outlet I30 has been completely removed, and wall has been sealed where the fountain used to be.

Facility has already repaired fixtures B and I30. Additionally, LPAs observed notification of lead results posted and presented at the facility entry.

Due to water outlets B and I30 testing above approved lead levels, a deficiency has been cited. See LIC809D for Type B Deficiency.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PSD/FONTANA CITRUS HEAD START	FACILITY NUMBER: 364818441
	VISIT DATE: 04/28/2023

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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:

(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. LPAs provided site supervisor, Alondra Ladison with a copy of this report and notice of site visit. Notice of site visit must remain posted for the next 30 days.

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: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/28/2023 10:51 AM - 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: PSD/FONTANA CITRUS HEAD START	FACILITY NUMBER: 364818441
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/28/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/29/2023 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:	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, removed or retested pursuant to section CCR 101705 and returns a result at or below the Acton level. Facility will notify CDSS with completion within 30 days.
	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 B (8.8 ppb) and I30 (6.2 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: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC809 (FAS) - (06/04)

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