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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426203096
Report Date: 11/03/2022
Date Signed: 11/03/2022 11:28:23 AM

Document Has Been Signed on 11/03/2022 11:28 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CAC - LOS ADOBES CENTERFACILITY NUMBER:
426203096
ADMINISTRATOR:GEORGINA SANTOYFACILITY TYPE:
850
ADDRESS:1026 W. BOONETELEPHONE:
(805) 928-0044
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 17TOTAL ENROLLED CHILDREN: 17CENSUS: 6DATE:
11/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Rebecca RomeroTIME COMPLETED:
11:35 AM
NARRATIVE
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On November 3, 2022 at 10:00 AM, Licensing Program Analysts (LPAs) Francisco Pedroza and Francisca Velazquez conducted an unannounced Case Management inspection to follow-up on an Action Level Exceedance (ALE) reported to the Regional Office by WWD. LPA's met with facility Site supervisor, Rebecca Romero and advised her the purpose of the inspection. LPA's took a tour of the facility inside and out. There were six (6) children in care at the time of the inspection.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five (5) years after the date of the first test. If the water testing results indicate that the facility has an ALE, an immediate response shall be required pursuant to section 101700.3, which may include remediation.

The Regional Office received an ALE for one (1) water outlets in this facility. The Center was notified by LPA Pedroza of the results on November 2, 2022 by phone. LPA advised site supervisor that sink letter (B) in the outdoor yard had an ALE of 12.0 ppb. Site Supervisor advised the sink used to be used for drinking water, but it has not been in use since the beginning of COVID-19.

During today’s inspection, LPA's toured the entire facility and inspected the outlet in question. LPA's observed that the sink was secured and made inaccessible to children in care. LPA observed a cart with children items places in front of the sink to ensure the sink is inaccessible to children in care. LPA's observed a gallon of filtered water and disposable cups within reach of children. Site supervisor advised that the sink is not used all by staff or children.

LPA's advised the testing report must be posted and parents/authorized representative informed of the ALE. Site supervisor advised this building is owned by the housing authority and they are planning on doing renovations within the next couple months. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CAC - LOS ADOBES CENTER
FACILITY NUMBER: 426203096
VISIT DATE: 11/03/2022
NARRATIVE
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Site supervisor reported that the sink will be fixed during the facility renovations.

LPA's provided a copy of PUB 515 and discussed the need for the Center to share this with families, discussed a plan of correction with the site supervisor and informed site supervisor the Plan of Correction for lead exceedances must include notification of parents and information about what has been done (their current response, such as water fixture put out of use, and bottled water provided) and remediation plans for all water outlets. LPA's informed site supervisor that parents must acknowledge receipt of licensing report and POC.

LPA's shared the following resources quick references:

Quick references:
· PIN 22-06-CCP - Lead Testing in Child Care Centers – Frequently Asked Questions
· PIN 21-21-CCP - Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370

A type B deficiency is being cited today. See attached 809D.

Exit interview conducted and report was reviewed with the Site Supervisor. Appeal rights were provided to Site supervisor.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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Document Has Been Signed on 11/03/2022 11:28 AM - It Cannot Be Edited


Created By: Francisca Velazquez On 11/03/2022 at 11:10 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CAC - LOS ADOBES CENTER
FACILITY NUMBER: 426203096

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2022
Section Cited

101700.3(b)(1)

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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 ... the Action Level. (1) A result with values of 5.5 ppb ... shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:
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Facility has taken the following steps: Shutoff sink and made inaccessible to chidlren inc are. Facility is currently working with housing authority to fix the exceedance in lead. Facility and will notify parental notification of the water testing results. Facility has until 12/02/2022 to correct the deficiencies or have a reasonable plan
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Facility conducted water lead testing and had one (1) outlet exceeded the action level exceedance per regulations. This poses a potential risk to the health and safety of the children in care
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 to correct them and notify CCL.

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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:Maria Mueller
LICENSING EVALUATOR NAME:Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022


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