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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700561
Report Date: 12/06/2022
Date Signed: 12/06/2022 03:08:16 PM


Document Has Been Signed on 12/06/2022 03:08 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:E.E.S. HANNALEI PRESCHOOLFACILITY NUMBER:
376700561
ADMINISTRATOR:IVONNE MARTINEZFACILITY TYPE:
850
ADDRESS:120 HANNALEI DRIVETELEPHONE:
(760) 643-2412
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:24CENSUS: 21DATE:
12/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ivonne Martinez-Site DirectorTIME COMPLETED:
03:30 PM
NARRATIVE
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On December 6, 2022 at 2:15 PM Licensing Program Analyst (LPA) Andrea Taylor, conducted a Case Management visit in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPA Taylor met with Ivonne Martinez, Site Director (SD) who was informed of the reason for the visit.

Assembly Bill 2370, Chapter 676, Statutes of 2018, added Health and Safety Code section 1597.16 requiring all licensed Child Care Centers constructed before January 1, 2010, test their water for lead between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first lead testing.

During the visit, LPA Taylor toured the facility and observed the water faucet identified as having high levels of lead. The sink is located in the classroom next to the door. The SD told LPA that the sink was immediately turned off and placed out of service until the plumber could come and replace the faucet.
There is a drinking fountain faucet on the side of the sink which does not work and was not tested because it does not work.

Interviews with staff revealed the faucet is used for hand washing and refilling drinking cups with the use of a filter.

See LIC 809D for cited deficiency in accordance with the California Code of Regulations Title 22, Division 12.

An exit interview was conducted with SD. A copy of this report, appeal rights and a Notice of Site Visit was issued.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2022
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 12/06/2022 03:08 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501


FACILITY NAME: E.E.S. HANNALEI PRESCHOOL
FACILITY NUMBER: 376700561

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2023
Section Cited

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Lead Exceedance Level Exceedance Response Requirements: (a) If a drinking water outlet test results in an Action Level Exceedance, the use of that outlet for drinking and food preparation purposes shall immediately cease until it is replaced and retested pursuant to section 101705 and returns a result at or below the Action Level.
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This requirement is not met as evidenced by:
water test results with level of lead exceeding the allowed level allowed.
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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: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2022
LIC809 (FAS) - (06/04)
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