<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700204
Report Date: 12/01/2022
Date Signed: 12/01/2022 12:29:03 PM


Document Has Been Signed on 12/01/2022 12:29 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:WARREN-WALKER SCHOOLFACILITY NUMBER:
376700204
ADMINISTRATOR:SHELLY BAKERFACILITY TYPE:
850
ADDRESS:5150 WILSON STREETTELEPHONE:
(619) 697-8308
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:55CENSUS: 10DATE:
12/01/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:TIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/01/2022 at 11:00 AM, Licensing Program Analyst Dana Stevens made an unannounced CASE MANAGEMENT inspection, for reported Lead Exceedance. LPA met with Lead Teacher, Belinda Delgadillo. Facility was within ratio & capacity. LPA interviewed Ms. Delgadillo and examined the water source (spigot) deemed at Action Level Exceedance.

Spigot reported with 5.5 ppb or greater lead exceedance levels are as follows:

Drinking Fountain on Playground Spigot D (not for children use) 37.000 ppb

Ms. Delgadillo stated that the spigot has not been used for over 3 years and LPA observed spigot has been covered and labeled not for use. Ms. Delgadillo stated the Center only uses bottled water for drinking and Center provides bottled water for all enrolled children and all staff. All spigots inside the facility are not in exceedance. All staff have been informed not to use spigot in exceedance for any reason.

See LIC809D for Type B deficiency cited.

Exit interview conducted. Appeal rights were discussed and given to Ms. Delgadillo on this date. Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana StevensTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 12/01/2022 12:29 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: WARREN-WALKER SCHOOL
FACILITY NUMBER: 376700204

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2022
Section Cited

1
2
3
4
5
6
7
101700.3(b)(1) Written Directives: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement was not met as evidenced by:

8
9
10
11
12
13
14
Based on water testing results and interview, facility tested over the Action Level Exceedance at one water outlet (spigot). This may pose a health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14

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: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana StevensTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2