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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 540404140
Report Date: 01/23/2023
Date Signed: 01/23/2023 01:00:08 PM


Document Has Been Signed on 01/23/2023 01:00 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:RICHGROVE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
540404140
ADMINISTRATOR:PARMA-PEREZ, VIRGINIAFACILITY TYPE:
850
ADDRESS:20812 GROVE DRIVETELEPHONE:
(661) 725-0144
CITY:RICHGROVESTATE: CAZIP CODE:
93261
CAPACITY:99CENSUS: 31DATE:
01/23/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Site Supervisor, Lorena LopezTIME COMPLETED:
01:20 PM
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On 01/12/23, Licensing Program Analyst (LPA) Jose Penate conducted an unannounced case management inspection. LPA met with Site Supervisor, Lorena Lopez for the purpose of conducting a case management inspection, regarding 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.

Fresno Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from Child Care Center Lead Sampling and Reporting Tool and self reported information to license #540404140, outlets impacted with an (ALE) of 8.1 ppb outlet C located in kitchen and outlet D in classroom #3. This result indicates out of compliance over (ALE) 5.5 ppb. (See Plan of correction for further corrective action 809D). Outlets have temporarily been made inoperable and is in the planning stages of repair. Site Supervisor agrees to continue with the re-sampling process for an action level result of under 5.5 ppb for compliance with a Certified Sampler. Site Supervisor stated children are provided water from a potable purified water that is delivered from a vendor. Facility will post results for parents to review Per PIN 21-21-1 CCP WD 101703 (b). In addition parents and guardians will be by letter and verbally of the (ALE ) Per PIN 21-21-1 CCP WD 101704 (b)(3).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809 D).

Site Supervisor was provided a copy of appeal rights. An exit interview was conducted.

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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2023
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 01/23/2023 01:00 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: RICHGROVE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 540404140

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/10/2023
Section Cited

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(a) California’s Action Level for lead in water at Child Care Centers is 5 ppb. (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. Testing results with fractional ppb readings of less than 0.5 ppb shall be rounded
down to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. (2) Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. (c) If testing indicates an Action Level Exceedance at any water outlet, the water from that outlet is deemed not safe to drink and an immediate response pursuant to section 101704 shall be required.
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Site Supervisor agrees to submit evidence of replacement and remediation on outlet C in the Kitchen and outlet D in classroom 3 testing at or below Action Level by POC due date 03/10/23. Director agrees to notified parents and guardians and posted (ALE) results at a reasonable location for Authorized Representatives to review as soon as possible.
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This requirement was not met evidence by: Based on record review provided by licensee indicating (ALE) of 8.1 ppb in outlet C and 5.5 ppb in outlet D. These results indicate out of compliance over (ALE) 5.5 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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2023
LIC809 (FAS) - (06/04)
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