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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806086
Report Date: 02/15/2023
Date Signed: 02/15/2023 10:54:15 AM


Document Has Been Signed on 02/15/2023 10:54 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:MANCHESTER FAMILY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
370806086
ADMINISTRATOR:SARAH KIMBALLFACILITY TYPE:
850
ADDRESS:1752 VIA LAS CUMBRESTELEPHONE:
(619) 260-4620
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY:60CENSUS: 41DATE:
02/15/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Sarah KimballTIME COMPLETED:
11:00 AM
NARRATIVE
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On 2/15/23 at 10:15 AM Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced Case Management inspection, due to Facility's failure to complete lead testing of water outlets prior to 1/1/23 . LPA Mangina met with Director, Sarah Kimball Also present in the facility were 41 daycare children in 4 classrooms with 4 teachers and one aid. Facility was within ratio & capacity.

LPA interviewed staff and examined drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and required forms (LIC 9275/9276) to Department on 2/15/23.

Faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows:

Outside drinking fountain "G" 290 ppb.

Director reported that the faucet in exceedance will be capped within the next week and has been masked. Children have been drinking bottled waterin (individual bottles since March 2020..



See LIC809-D for type B deficiency cited.

Exit interview conducted and report was reviewed with the facility representative, Sarah Kimball. A copy of PIN 21-21-CCP was provided. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023
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 02/15/2023 10:54 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: MANCHESTER FAMILY CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 370806086

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2023
Section Cited

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A licensed child day care center...shall have its drinking water tested for lead contamination levels... no later than January 1, 2023... “A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.”

This requirements was not met as evidenced by:
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Facility Representative states wll cap the outlet and remove fixture and provide proof to LPA no later than 3/1/23.
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Based on water testing results and interviews, facility tested outlets on 1/4/23 and over the Action Level Exceedance was found at one outlet (G) which poses a potential health, safety or personal rights 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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023
LIC809 (FAS) - (06/04)
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