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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801382
Report Date: 01/13/2023
Date Signed: 01/13/2023 10:23:36 AM


Document Has Been Signed on 01/13/2023 10:23 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:PORTERVILLE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
543801382
ADMINISTRATOR:RODRIGUEZ, BEATRIZFACILITY TYPE:
850
ADDRESS:254 WEST ORANGETELEPHONE:
(559) 781-0145
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:75CENSUS: 34DATE:
01/13/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sheila HernandezTIME COMPLETED:
10:25 AM
NARRATIVE
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On 01/13/23 Licensing Program Analysts (LPAs) Daniel Alvarez and Ruby Ocegueda conducted an unannounced case management inspection. LPA Alvarez met with Site Supervisor Sheila Hernandez who accompanied LPAs on a tour of the facility, and a census was taken. The purpose of today's inspection is to address the lead exceedance, referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

The Fresno South Regional Office received notification of water lead exceedance at the facility resulting from a water lead sampling test collected on 11/16/2022. Records were reviewed from BSK Associates and discussions with Site Supervisor Sheila Hernandez, it has been determined that there is an exceedance to outlets (A) and (B) in the facility. LPA Alvarez inspected outlet (A) it was observed to be a kitchen sink faucet that was impacted with 16ppb (ALE) of lead. LPA Alvarez also inspected outlet (B) it was also observed to be a kitchen sink faucet that was impacted with 9.1ppb (ALE) of lead. Facility has made both faucets inoperable to preschool by placing a sign on the faucets and faucets have been wrapped not to use until faucets have been retested. Site Supervisor Sheila Hernandez stated that all water for food prep is being used from faucet (C) which had a “none detected” level.

(See plan of correction for further corrective action 809D). Facility has already notified all the authorized representatives of this corrective action in English.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809D). Site Supervisor Sheila Hernandez was provided a copy of the appeal rights. An exit interview was conducted with Site Supervisor Sheila Hernandez.
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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2023
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 01/13/2023 10:23 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: PORTERVILLE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 543801382

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/13/2023
Section Cited

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California Action Level at Child Care Centers (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number ... (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE). This requirement was not met as evidenced by
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Per Site Supervisor affected outlets have been replaced, facility is conducting daily flushing for three weeks and will have a second water lead sampling test and notify Community Care Licensing (CCL) of results.
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Based on record review, two outlets at the facility contained lead exceedance greater than 5.5 ppb. This poses a potential health, safety or personal rights risk to persons in care.
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Facility has notified all parents/authorized representatives of ALE, and of any corrective action already taken at the facility.

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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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 01/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2023
LIC809 (FAS) - (06/04)
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