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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070215143
Report Date: 01/31/2023
Date Signed: 01/31/2023 02:15:28 PM

Document Has Been Signed on 01/31/2023 02:15 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:STEPPING STONES LEARNING CENTER IIFACILITY NUMBER:
070215143
ADMINISTRATOR:DELGADO, STEPHANFACILITY TYPE:
840
ADDRESS:2691 CROW CANYON ROADTELEPHONE:
(925) 820-8820
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 0DATE:
01/31/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Bona NaTIME COMPLETED:
02:25 PM
NARRATIVE
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On January 31, 2023 at 12:45pm, Licensing Program Analyst (LPA) Julia Placencia conducted a case management inspection due to the center's lead testing results. LPA met with licensee Bona Na. There were no children and staff present as the program has not been in operation since the summer of 2021.

The department was notified that water faucets “G” and “H”, located in the school age "Zoo Crew" class, have elevated lead levels that have exceeded 5.5 ppb. This exceeds the Action Level (ALE) established by the state for lead exposure. Per director Steve Delgado, these faucets were immediately closed off and have now been replaced. LPA observed today the faucets are closed and not in use. LPA also observed posting of lead testing results.

See LIC809D for deficiencies cited during today's inspection.



Exit interview conducted with licensee Bona Na. A notice of site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2023
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 01/31/2023 02:15 PM - It Cannot Be Edited


Created By: Julia Placencia On 01/31/2023 at 01:23 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: STEPPING STONES LEARNING CENTER II
FACILITY NUMBER: 070215143

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2023
Section Cited

101700.3(b)(1)

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101700.3(b)(1)-Lead Testing Written Directive-
A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE)
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LPA observed the 2 water outlets have been closed and replaced. Director is advised to submit re-test results to LPA by due date of 2/28/23.
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This requirement is not met as evidenced by:
Based on record review, the facility has 2 outlets ("G" and "H") that have an ALE of ppb or greater, 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:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2023


LIC809 (FAS) - (06/04)
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