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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419407
Report Date: 04/13/2023
Date Signed: 04/13/2023 02:36:03 PM

Document Has Been Signed on 04/13/2023 02:36 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LITTLE SEEDS CHILDREN'S CENTERFACILITY NUMBER:
013419407
ADMINISTRATOR:ALCONTIN, IMELDAFACILITY TYPE:
850
ADDRESS:2055 SANTA CLARA AVE.TELEPHONE:
(510) 865-5900
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 25DATE:
04/13/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:13 PM
MET WITH:TIME COMPLETED:
02:45 PM
NARRATIVE
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On 4/13/23 at 1:10pm, Licensing Program Analyst (LPA) Catherine Fernandes met with Director Sarah Hallford to conduct an unannounced case management inspection regarding a lead exceedance from two faucets in the center. The water sources exceeded the acceptable amount of lead allowed in a child care center. During the unannounced inspection LPA toured the facility for a health and safety check. There were 25 preschoolers in care with an additional six staff members.

The first water source is the kitchen sink, LPA observed a sign placed above the sink stating "do not use for drinking or preparing food".

The second water source is the water fountain located in the outdoor preschool play area, Director stated that the water fountain has not been used since COVID. LPA asked the center to turn off the water source which was done during the inspection.

Director stated they are in the process of repairing the two sources.

See 809-D for deficiency.



Exit interview conducted.
Report and Appeal Rights provided to Directed Sarah Hallford.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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 04/13/2023 02:36 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 04/13/2023 at 02:10 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LITTLE SEEDS CHILDREN'S CENTER
FACILITY NUMBER: 013419407

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
05/12/2023
Section Cited

101700.3(b)(1)

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Lead Testing Written Directive
A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement has not been met as evidenced by:
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The facility will repair the faucets and retest to ensure water sources are safe to use. Then by POC date Director will submit retesting results to CCLD.
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Based on record review the center has two water sources that have a lead exceedance, which poses a potential Health and Safety risk to persons in care.
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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:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2023


LIC809 (FAS) - (06/04)
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