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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805052
Report Date: 03/02/2023
Date Signed: 03/02/2023 12:05:38 PM


Document Has Been Signed on 03/02/2023 12:05 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:WOW CHRISTIAN PRESCHOOLFACILITY NUMBER:
370805052
ADMINISTRATOR:SALLY GUTIERREZFACILITY TYPE:
850
ADDRESS:9140 AKARD STREETTELEPHONE:
(619) 267-0885
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:51CENSUS: 27DATE:
03/02/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Sally GutierrezTIME COMPLETED:
12:05 PM
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On 03/02/2023 at 11:20 am, Licensing Program Analyst (LPA), David Miller conducted an unannounced case management inspection for the Action Level Exceedance (ALE) of lead detected in facility water fixture. LPA met with Director, Sally Gutierrez. The purpose of the inspection was explained, and facility was toured. There were two (2) staff and six (6) children in the toddler classroom, one (1) teacher and nine (9) children in the early preschool/preschool class (combined today), and one (1) teacher and twelve (12) children present in the pre-K classroom.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

LPA Miller obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276) and Facility Sketch (LIC999), on 02/27/2023.

On 01/13/2023, the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 01/13/2023. The outlets/fixtures reported with 6.0 ppb or greater lead exceedance levels were as follows:

A – Drinking Fountain, located on the playground outside the Toddler classroom, currently not in use.

Facility no longer utilizes the drinking fountain on the playground. Director stated that the drinking fountain has not been in use since at least Summer of 2022. The water remains off and the facility has placed a sign that states “out of service, do not use” on the drinking fountain and covered with a plastic bag. Children bring their own water in sippy cups. Water is also provided by the facility from the water dispenser inside of the facility. See LIC 809C Continuation...

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: WOW CHRISTIAN PRESCHOOL
FACILITY NUMBER: 370805052
VISIT DATE: 03/02/2023
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Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: See LIC 809D. An exit interview conducted with Director, Sally Gutierrez. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 03/02/2023 12:05 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108


FACILITY NAME: WOW CHRISTIAN PRESCHOOL
FACILITY NUMBER: 370805052

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/02/2023
Section Cited

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101700.3 California Lead Action Level at Child Care Centers. (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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Director stated that the drinking fountain will be replaced or removed. Director will provide proof of replacement or removal of drinking fountain to LPA, no later than 04/14/2023.
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This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the directive above, as one (1) outlet used for drinking tested with an Action Level Exceedance (ALE). This poses a potential Health and Safety risk to children in care.
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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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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