<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801448
Report Date: 01/26/2023
Date Signed: 01/26/2023 03:58:42 PM


Document Has Been Signed on 01/26/2023 03:58 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:PIXLEY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
543801448
ADMINISTRATOR:HERNANDEZ, SHEILAFACILITY TYPE:
850
ADDRESS:300 N. SCHOOL ST.TELEPHONE:
(559) 757-9701
CITY:PIXLEYSTATE: CAZIP CODE:
93256
CAPACITY:25CENSUS: 0DATE:
01/26/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Maria TrevinoTIME COMPLETED:
04:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 01/24/2023 Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Case Management inspection and met with Substitute Site Supervisor Maria Trevino. 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.

Fresno South Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test conducted on 12/3/2022. Based on records reviewed from Child Care Center Lead Sampling and Reporting Tool outlet B was impacted with an (ALE) of 6.100ppb and outlet D was impacted with an (ALE) of 9.000ppb. Both outlets named B and D are located in the sole preschool classroom #1. These results indicates out of compliance of over (ALE) 5.5 ppb. (See Plan of correction for further corrective action LIC 809-D). Outlets B and D have been temporarily been made inoperable. Site Supervisor Trevino agrees to continue with the re-sampling process for an action level result of under 5.5 ppb for compliance with a Certified Sampler.

Supervisor Trevino stated each classroom maintains a portable Culligan water cooler with disposable cups. Culligan water is also put into Igloo containers for outside use.
The Potable water cooler is also made available for staff during hours of operation. Written notices in English and Spanish of ALE was provided to all parents. Written notices are also posted on the outside and inside parent boards 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, LIC 809-D). An exit interview was conducted with Maria Trevino and this report was reviewed and provided. A Notice of Site Visit (LIC 9213) and copy of Appeal Rights was also provided. 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: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023
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 01/26/2023 03:58 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: PIXLEY CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 543801448

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2023
Section Cited

1
2
3
4
5
6
7
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 (ALE)...(c) If testing indicates an (ALE) 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.
1
2
3
4
5
6
7
Per Site Supervisor Trevino, authorized representatives have been notified of the lead exceedance via written notice in English and Spanish. Outlets B and D have been made inoperable. Site Supervisor Trevino agrees to submit evidence of replacement and remediation of outlets B and D in the sole preschool classroom by testing at or below Action Level by POC due date of 2/27/2023.
8
9
10
11
12
13
14
This requirement was not met evidence by: Based on record review provided by licensee indicating ALE of 6.100ppb in outlet B and ALE of 9.000ppb 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.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2