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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810094
Report Date: 05/18/2023
Date Signed: 05/18/2023 02:18:55 PM

Document Has Been Signed on 05/18/2023 02:18 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:BELLEVIEW PS-PUSDFACILITY NUMBER:
543810094
ADMINISTRATOR:ORTEGA-ORTIZ, REBECCAFACILITY TYPE:
850
ADDRESS:534 N E STTELEPHONE:
(559) 782-7120
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 22DATE:
05/18/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Rebecca Ortega TIME COMPLETED:
02:30 PM
NARRATIVE
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On 5/18/23, Licensing Program Analyst Jessika Thompson conducted an unannounced case management inspection. LPA met with Director of Education, Rebecca Ortega, who accompanied LPA on a tour of the facility. The purpose of today's inspection was to address 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.

The Fresno South Regional Office received notification of a water lead exceedance at the facility resulting from a water lead sampling test collected on 3/21/2023. Records were reviewed from BSK Associates and it has been determined that there is an exceedance in outlets (B), (C),( D), & (F) at the facility. LPA inspected outlet (B); it was observed to be a drinking faucet in Classroom #2 that was impacted with 6.1 ppb (ALE) of lead. LPA inspected outlet (C); it was observed to be a drinking faucet in Classroom #3 that was impacted with 10 ppb (ALE) of lead. LPA inspected outlet (D); it was observed to be a drinking faucet in Classroom #4/ Breakroom that was impacted with 25 ppb (ALE) of lead. LPA inspected outlet (F), which observed to be a drinking faucet in outdoor play area that was impacted with 12 ppb (ALE) of lead. Licensee has made all aforementioned faucets inaccessible to preschool children by placing restrictive wrapping and signage over respective faucets. Facility staff have been made aware that the above listed faucets are not permitted for usage until water retesting and clearance. A Notification of lead exceedance information has been posted in pertinent areas of the facility. Director Ortega indicated that facility has bottled water readily available to children for drinking purposes. Today, LPA observed large containers full of bottled water in affected areas. (See plan of correction for further corrective action LIC809D).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, LIC809D).

Director Ortega was provided a copy of the appeal rights. An exit interview was conducted with Director Ortega. 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.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2023
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 05/18/2023 02:18 PM - It Cannot Be Edited


Created By: Jessika Thompson On 05/18/2023 at 01:42 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: BELLEVIEW PS-PUSD
FACILITY NUMBER: 543810094

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2023
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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Based on record review, four outlets at the facility contained lead exceedances 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 Fanning
LICENSING EVALUATOR NAME:Jessika Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023


LIC809 (FAS) - (06/04)
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