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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566211800
Report Date: 02/15/2024
Date Signed: 02/15/2024 02:16:17 PM


Document Has Been Signed on 02/15/2024 02:16 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:PACIFIC CAMPS OXNARDFACILITY NUMBER:
566211800
ADMINISTRATOR:ED HARLEYFACILITY TYPE:
840
ADDRESS:850 IVYWOOD DR.TELEPHONE:
(805) 983-0214
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY:100CENSUS: 0DATE:
02/15/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:46 PM
MET WITH:Nathaniel VaneardenTIME COMPLETED:
02:25 PM
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On February 15, 2024 Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced
Case Management inspection to follow-up on an Action Level Exceedance (ALE) reported to the Regional Office. LPA met with Nathaniel Vanearden, site supervisor of the above-mentioned Child Care Center (CCC)
and informed of the nature of the inspection. LPA toured the interior and exterior of the CCC and notes no
children were on site at the time of arrival and no other adults present.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five (5) years after the date of the first test. If the water testing results indicate that the facility has an ALE, an immediate response shall be required pursuant to section 101704, which may include remediation.

LPA review the CCC's Lead Test findings on the Child Care Lead Sampling and Tool Site which noted six (6) locations in the CCC which exceeded 5.5 parts per billion (ppb). Director provided LPA the water lead testing documentation provided by the certified water sampler. Upon reviewing the documentation, LPA notes five (5) out of the six (6) locations which exceeded 5.5 ppb are hand washing sinks. Moreover, children do not consume water from the locations/areas noted and no food is prepared at the CCC. One location that exceeded 5.5 ppb is located in the outdoor play area and is used for drinking. Site supervisor states the drinking fountain has been replaced. LPA asked if the water fountain has been re-tested since the replacement, Nathaniel states no. LPA advised Nathaniel that Pursuant to section 101704 of the Written Directives for lead testing, outlets that have been replaced as part of a Plan of Correction (POC) shall be conditioned to the water at the child care center, resampled, and return a result at or below the Action Level prior to using the outlet for drinking or cooking.
Continued on 809-C
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: PACIFIC CAMPS OXNARD
FACILITY NUMBER: 566211800
VISIT DATE: 02/15/2024
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LPA cleared the ALE notices on the Child Care Lead Sampling and Tool Site and notes the CCC provides filtered and bottled water to children in care.

Per PIN 21-21-CCP, the following outlet locations should be sampled: cold water faucets and fountains, cold
water side of single-handle and dual-handle faucets that dispense both hot and cold water, filtered water dispensers, and water dispensed by refrigerators used for drinking and cooking water.

LPA provided a copy of PUB 515 and Lead Testing in Child Care Centers – Frequently Asked Questions as well as shared the following resources quick references:

Quick references:
· PIN 21-21-CCP - Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370

Site supervisor placed cover on outside water fountain to prevent children from having access.

No deficiency was cited during today's inspection and a Notice of Site Visit (LIC 9213) along with Appeal Rights (LIC 9058) were provided to site supervisor Nathaniel Vanearden.

Director was directed to post the Notice of Site Visit for 30 days or a civil penalty of $100 may apply.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC809 (FAS) - (06/04)
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