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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543808548
Report Date: 02/23/2023
Date Signed: 02/23/2023 11:16:05 AM


Document Has Been Signed on 02/23/2023 11:16 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:PORT NAZ CHRISTIAN ACADEMYFACILITY NUMBER:
543808548
ADMINISTRATOR:PITCHER, KARENFACILITY TYPE:
850
ADDRESS:2005 W. OLIVE AVENUETELEPHONE:
(559) 784-5437
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:96CENSUS: 47DATE:
02/23/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Karen PitcherTIME COMPLETED:
11:30 AM
NARRATIVE
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On 02/23/23 Licensing Program Analysts (LPAs) Daniel Alvarez and Candis Rodriguez conducted an unannounced case management inspection. LPA Alvarez met with Director Karen Pitcher 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 08/13/2022. Records were reviewed from Enthalpy Analytical and discussed with Director Karen Pitcher, it has been determined that there is an exceedance to outlets (B), (C), (D), (I), (L), (N) and (O)in the facility. LPA Alvarez inspected outlet (B) it was observed to be a sink faucet in room 4 that was impacted with 12ppb (ALE) of lead. LPA Alvarez inspected outlet (C) it was also observed to be a sink faucet in room 5 that was impacted with 18ppb (ALE) of lead. LPA Alvarez inspected outlet (D) it was also observed to be a sink faucet in room 2 that was impacted with 6.4ppb (ALE) of lead. LPA Alvarez inspected outlet (I) it was also observed to be a sink faucet in room 9 that was impacted with 16ppb (ALE) of lead. LPA Alvarez inspected outlet (L) it was observed to be a drinking fountain in room 3 that was impacted with 7.2ppb (ALE) of lead. LPA Alvarez inspected outlet (N) it was also observed to be a drinking fountain in room 6 that was impacted with 14ppb (ALE) of lead. Lastly LPA Alvarez inspected outlet (O) it was also observed to be a drinking fountain in room 9 that was impacted with 7.9ppb (ALE) of lead.
(CONTINUED ON 809-C)

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2023
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 02/23/2023 11:16 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: PORT NAZ CHRISTIAN ACADEMY
FACILITY NUMBER: 543808548

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2023
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 Director the affected sink faucets have been replaced, but two sink faucets still came back with ALE. Facility is working with the State Water Board to determined what correction measure to take, and will have a third water lead sampling test and notify Community Care Licensing (CCL) of results. The three drinking fountains will be permanently removed.
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Based on record review, seven 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 will notify all parents/authorized representatives of any corrective action already taken at the facility. Director stated she will conduct a follow up water sample as outlined in Written Directives Section 101705 and submit all required documentation to CCL by 03/27/2023.

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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: 02/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3


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: PORT NAZ CHRISTIAN ACADEMY
FACILITY NUMBER: 543808548
VISIT DATE: 02/23/2023
NARRATIVE
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Facility has made all faucets inoperable to preschool by placing a sign on the faucets and faucets have been wrapped not to use until faucets have been retested. Director Karen Pitcher stated that all water for drinking is now being supplied by bottle waters provided by the facility and since Covid children have been instructed to bring their own water cups.

(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). Director Karen Pitcher was provided a copy of the appeal rights.

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: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3