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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600360
Report Date: 02/17/2023
Date Signed: 02/17/2023 09:44:09 AM


Document Has Been Signed on 02/17/2023 09:44 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:KINDERCARE AGEE PRESCHOOLFACILITY NUMBER:
376600360
ADMINISTRATOR:BIBIANCA JIMENEZFACILITY TYPE:
850
ADDRESS:6150 AGEE STREETTELEPHONE:
(858) 453-7530
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:100CENSUS: 32DATE:
02/17/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Melissa Overland-McKayTIME COMPLETED:
09:50 AM
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On 2/17/23 at 8:30am, LPA Patrick Ma made an unannounced CASE MANAGEMENT inspection, for reported Lead Exceedance. LPA met with Director, Melissa Overland-McKay. Also present in the facility were 32 daycare children, 4 teachers and a Assistant Director. Facility was within ratio & capacity. LPA examined the water outlets deemed an Action Level Exceedance.

Water outlets reported with 5.5 ppb or greater lead exceedance levels were as follows:

Unused Classroom Children’s hand washing sink C 5.7 ppb
2’s Classroom Children’s hand washing sink F 12.0 ppb

Director reported, all outlets in exceedance were not used for food preparation or drinking water. Since testing results, all staff have been informed not to use the faucets for drinking water or food preparation and signs have been posted by the outlets reminding others they are for hand washing only and not for food preparation or drinking. Food preparations is conducted in the kitchen and filtered drinking water is refilled from the kitchen faucet. Director stated both sink outlets were replaced on 12/28/22 but the signs will remain until retesting is completed and results show the outlets are no longer at or above exceedance level.

See LIC809D for deficiency cited.

Exit interview conducted and report was reviewed with the facility representative Melissa Overland-McKay. 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: Patrick MaTELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2023
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 02/17/2023 09:44 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: KINDERCARE AGEE PRESCHOOL
FACILITY NUMBER: 376600360

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2023
Section Cited

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101700.3(b)(1) Written Directives per AB2370: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement is not met as evidenced by:
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Corrections were made prior to visit. Director stated, all staff have been informed not to use the faucets for drinking water or food preparation. Signs have been posted by the sinks that they are for hand washing only. Director stated both sink outlets were replaced on 12/28/22 but the signs will remain until retesting is completed and results show the outlets are no longer at or above exceedance level.
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Based on water testing results and interviews, facility tested over the Action Level Exceedance level at 2 children’s sinks not used for food preparation or drinking. This 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: Patrick MaTELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2023
LIC809 (FAS) - (06/04)
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