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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600948
Report Date: 02/27/2023
Date Signed: 02/27/2023 12:06:40 PM


Document Has Been Signed on 02/27/2023 12:06 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:KINDERCARE LEARNING CENTER - EASTLAKE INFANTFACILITY NUMBER:
376600948
ADMINISTRATOR:SUMMER MEDINAFACILITY TYPE:
830
ADDRESS:2354 FENTON STREETTELEPHONE:
(619) 656-9853
CITY:CHULA VISTASTATE: CAZIP CODE:
91914
CAPACITY:36CENSUS: 30DATE:
02/27/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Summer MedinaTIME COMPLETED:
12:20 PM
NARRATIVE
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On February 27, 2023 at 9:30 am, Licensing Program Analysts (LPA), Gloria Gonzalez conducted an unannounced case management inspection for the Action Level Exceedance (ALE) of lead detected in facility water fixture. LPA met with Director, Summer Medina. The purpose of the inspection was explained, and facility was toured. Present in the facility were 30 children and eight (8) staff members.
 
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 obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276) and Facility Sketch (LIC999), on 1/6/23.
 
On 12/27/22, 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 12/10/22. The outlets/fixtures reported with 5.5 ppb or greater lead exceedance levels were as follows:
 
II – Drinking fountain located in the toddler playground has been capped off and is no longer in use. Director states children bring in lable cups for drinking water indoors and outdoors. 
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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: KINDERCARE LEARNING CENTER - EASTLAKE INFANT
FACILITY NUMBER: 376600948
VISIT DATE: 02/27/2023
NARRATIVE
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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, Summer Medina. 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: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 02/27/2023 12:06 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: KINDERCARE LEARNING CENTER - EASTLAKE INFANT
FACILITY NUMBER: 376600948

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2023
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 ... (1) 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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On 1/3/23, facility had water fountain - II capped off. LPA observed capped off water fountain. This POC has been cleared as of today.
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Based on record review, the licensee did not comply with the directive above, as one (1) outlet used for drinking and/or food preparation 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: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
LIC809 (FAS) - (06/04)
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