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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503600806
Report Date: 01/17/2023
Date Signed: 01/17/2023 11:46:25 AM


Document Has Been Signed on 01/17/2023 11:46 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:SALIDA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
503600806
ADMINISTRATOR:VANDER WEIDE, TANYAFACILITY TYPE:
850
ADDRESS:4519 FINNEY ROADTELEPHONE:
(209) 543-3102
CITY:SALIDASTATE: CAZIP CODE:
95368
CAPACITY:51CENSUS: 35DATE:
01/17/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jennifer BealTIME COMPLETED:
12:00 PM
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On January 17, 2023 Licensing Program Analyst (LPA) Kari McWilliams conducted an unannounced case management inspection. LPA McWilliams met with Supervisor Jennifer Beal. The purpose of today’s inspection was to conduct a case management inspection and to notify the facility that there has been a lead exceedance referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility. LPA conducted a tour of the facility inside and out and a census was taken.

Fresno North Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from Moore Twining Associates Inc. and discussions with Supervisor Beal it has been determined that there is an exceedance to outlets A, B, C and G in the facility.

LPA McWilliams inspected outlets A, B, C and G; it was observed to be three sinks and one drinking fountain that was impacted with 6.1 ppb, 21 ppb, 56 ppb and 15 ppb(ALE), respectfully of lead. Supervisor Beal, has discontinued the use of all sinks and drinking fountain by; replacing and flushing all outlets.

On November 14, 2022 Supervisor Beal received notification from Moore Twining Associates Inc, that outlets A and G passed with no lead exceedance. Outlets B and C still showed an exceedance; outlet B (drinking fountain) showed 69ppb and outlet C (faucet) showed 27ppb.

On December 16, 2022 outlets B and C were retested; on January 17, 2023 the results were received and Outlets B had a level of 5.3ppb and C had a level of 6.1ppb. The outlets are still inoperable at this time and a plan of action is being assessed.

(See plan of correction for further corrective action 809D). Supervisor Beal has notified authorized representatives of this corrective action in both languages; English and Spanish.
SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SALIDA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 503600806
VISIT DATE: 01/17/2023
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Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809D). Supervisor Beal was provided a copy of the appeal rights. An exit interview was conducted with Supervisor Beal.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 01/17/2023 11:46 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: SALIDA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 503600806

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2023
Section Cited

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(a)California’s Action Level for lead in water at Child Care Centers is 5ppb.(b) Testing results with fractional ppb readings of 0.5ppb or greater shall be rounded up...(1) A result with values of 5.5ppb or greater... Action Level Exceedance. (c) If testing indicates an Action Level Exceedance at any water outlet,the water from that outlet is deemed not safe...
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Supervisor Beal has ensured outlets are inoperable until levels are deemed safe. LPA observed outlets made inoperable, Supervisor has ensured that all guardians have been notified and outlets still out out of compliance are inoperable and a plan of action is being assessed. Supersor Beal will send in new test results when available.
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 immediate response...This requirement was not met by evidence by:Based on record review provided by Moore Twining Ass.a result of (ALE) 6.1 for outlet A, 21ppb for outlet B, 56ppb for outlet C and 15ppb for outlet G which is out of compliance over the allowable ALE 5.5ppb. This 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: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023
LIC809 (FAS) - (06/04)
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