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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408775
Report Date: 01/31/2023
Date Signed: 01/31/2023 11:41:34 AM


Document Has Been Signed on 01/31/2023 11:41 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:LIFECONNECTIONS CHILDREN'S LEARNING CENTERFACILITY NUMBER:
434408775
ADMINISTRATOR:MEGHAN GALAZZOFACILITY TYPE:
840
ADDRESS:800 BARBER LANETELEPHONE:
(408) 853-2196
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:63CENSUS: DATE:
01/31/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Meghan GalazzoTIME COMPLETED:
12:00 PM
NARRATIVE
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On Tuesday, January 31, 2023 at 9:30 am, Licensing Program Analyst (LPA) Manel Estoesta conducted a Case Management - Lead Testing/Exceedance Visit. LPA met with the Director Meghan Galazzo and explained the nature of the visit.

LPA discussed to the Director the PIN 21-21.1-CCP - WRITTEN DIRECTIVES FOR LEAD TESTING OF WATER IN LICENSED CHILD CARE CENTERS (CCC) PURSUANT TO AB 2370 CHAPTER 676, STATUTES OF 2018 https://www.cdss.ca.gov/Portals/9/CCLD/PINs/2021/CCP/PIN-21-21_1-CCP.pdf
Health and Safety (HSC) Code section 1597.16 authorizes the Department to implement and administer the health and safety requirements related to lead exposure and testing at CCCs through written instructions until it adopts regulations under the Administrative Procedure Act.

The facility Sample ID's 434404322 D & L had a Lead Action Level of Exceedance Response. Sample taken on 10/01/2022 and Date of Analysis on 10/4/2022. Water Sample Results Reported on 10/10/2022. The facility developed a Plan of Correction and Authorized Representative Notification via email on 10/26/2022. The facility Remediation plan by replacement of the water outlets completed 11/26/2022. Water outlets resampled on 01/07/2023 and Date of Analysis on 01/10/2023. An outlet with Sample ID 434404322 B30 (previously 434404322 L) came back with a Lead Action Level of Exceedance Response. The facility is currently working of a plan to install a lead filtration system on water outlet and will then retest them once the installation has been completed.

This facility is being given a Type B citation for California Code of Regulations, Title 22, Division 12 Chapter 1 Regulation number: 101238(a) Buildings and Grounds. Please see LIC 809D page for the citation. LPA generated a Proof of Correction Clearance Letter and provided a copy to the Director.

Exit interview was conducted with the Director Meghan Galazzo.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2023
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 01/31/2023 11:41 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: LIFECONNECTIONS CHILDREN'S LEARNING CENTER
FACILITY NUMBER: 434408775

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/01/2023
Section Cited

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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.....
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The facility Remediation plan by replacement of the water outlets completed on 11/26/2022. During the remediation plan, bottled water is being used in place of water outlets that are out of service.
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The facility Sample ID's 434404322 D & L had a Lead Action Level of Exceedance Response which poses a potential health, safety and personal rights risk to children in care.
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Water outlets resampled on 01/07/2023 and Date of Analysis on 01/10/2023. Notification has been sent out to all parents or guardians.

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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) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2023
LIC809 (FAS) - (06/04)
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