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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430702587
Report Date: 10/07/2022
Date Signed: 10/07/2022 11:03:26 AM


Document Has Been Signed on 10/07/2022 11:03 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:LEARNING CENTER, THEFACILITY NUMBER:
430702587
ADMINISTRATOR:EVANS-FITCH, PAULAFACILITY TYPE:
850
ADDRESS:459 KINGSLEY AVETELEPHONE:
(650) 325-6683
CITY:PALO ALTOSTATE: CAZIP CODE:
94301
CAPACITY:40CENSUS: 27DATE:
10/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Paula Evans-FitchTIME COMPLETED:
11:15 AM
NARRATIVE
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On October 7, 2022 at 9:40am, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced to conduct a case management inspection due to the center's lead testing results. LPA met with director Paula Evans-Fitch. There were 27 children and an additional 6 staff members present.

It has been determined that there is one water faucet in the facility that has elevated lead levels established by a Certified External Water Sampler.

See LIC809D for deficiencies cited during today's inspection.

Exit interview conducted with director Paula Evans-Fitch. A notice of site visit was provided and must be posted for 30 days.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
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 10/07/2022 11:03 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: LEARNING CENTER, THE
FACILITY NUMBER: 430702587

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/07/2022
Section Cited

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101700.3(b)(1) Lead Testing Written Directive-
A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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This requirement is not met as evidenced by:
Based on record review, the licensee did not comply with the section cited above, which is a potential health and safety risk to persons in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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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: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2