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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709132
Report Date: 08/25/2023
Date Signed: 08/25/2023 01:42:11 PM


Document Has Been Signed on 08/25/2023 01:42 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:MONTECITO PRESCHOOLFACILITY NUMBER:
430709132
ADMINISTRATOR:ERIN MOBLEYFACILITY TYPE:
850
ADDRESS:1468 GRANT ROADTELEPHONE:
(650) 968-5957
CITY:LOS ALTOSSTATE: CAZIP CODE:
94024
CAPACITY:91CENSUS: 63DATE:
08/25/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Erin MobleyTIME COMPLETED:
11:00 AM
NARRATIVE
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On 08/25/2023 at 9:15am, Licensing Program Analyst (LPA) Christina Uribe conducted an unannounced visit to the facility for the purpose of a Case Management visit to discuss the results of recent lead testing performed. LPA met with Director, Erin Mobley. Also present during today's inspection was 63 children and 19 staff.

A lead test completed for water locations intended for human consumption for faucets within the facility. On 10/18/2022, samples were collected from 14 faucets within the facility. 1 faucet, labeled "I" is a drinking fountain attached to an outdoor hand washing station in the Meadow Room playground which test results showed a level of 8.510 ppb level of lead. A result of 5.5 ppb or greater is deemed an Action Level Exceedance and requires the issuance of a deficiency and a Plan of Correction. The remaining 13 faucets that were tested had results either below 5.5 ppb or had no measurable level of lead detected, "Analyte Not Detected - ND".

Though this faucet with an ALE was never used for drinking or food preparation by the facility, the drinking faucet feature was permanently removed from the hand washing station after the facility received the lab results showing the ALE in November 2022. The facility made the decision to permanently remove the faucet prior to CCLD intervention.

LPA Uribe obtained proof that the deficiency was corrected and took photos of the permanently removed drinking fountain feature at the outdoor hand washing station. The licensee had previously sent photos of this removed faucet to the Water Board and CCLD on 12/13/2022.

A Type B Deficiency was issued today, see LIC 809D. A Notice of Site Visit was given and must be posted for 30 days. Appeal rights were given and reviewed. Exit interview conducted and report was reviewed with the director, Erin Mobley.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina UribeTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2023
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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Document Has Been Signed on 08/25/2023 01:42 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: MONTECITO PRESCHOOL
FACILITY NUMBER: 430709132

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/25/2023
Section Cited
CCR
101238(a)

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101238 Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by:
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The facility has already permanently removed the drinking fountain feature on the hand washing station in late November 2022 after the facility received the lab report showing the ALE prior to CCLD intervention. LPA Uribe verified that the facility has permanently removed the fountain feature with ALE.
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One outdoor drinking fountain attached to the handwashing station, whichthe facility never used for drinking or food preparation, was tested for lead and the results showed a level of 8.510 ppb, which poses a potential health, safety, or personal rights risk to persons 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: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina UribeTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2023
LIC809 (FAS) - (06/04)
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