073406683-4-27-2023-02-CC-THAR-CRAUG2-20230427153337

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406683
Report Date: 04/27/2023
Date Signed: 04/27/2023 03:33:43 PM

Document Has Been Signed on 04/27/2023 03:33 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:	WOOD ROSE ACADEMY AND PRESCHOOL		FACILITY NUMBER:	073406683
ADMINISTRATOR:	HARISDELSY CARDENAS		FACILITY TYPE:	850
ADDRESS:	4347 COWELL ROAD		TELEPHONE:	(925) 825-4644
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY: 72	TOTAL ENROLLED CHILDREN: 72	CENSUS: 42	DATE:	04/27/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	HARISDELSY CARDENAS		TIME COMPLETED:	04:00 PM

NARRATIVE

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Licensing Program Analyst Tasha Alexander met with Center director Harisdelsy Cardenas for an UNANNOUNCED CASE MANAGEMENT inspection. Today there are 42 children present along with 8 staff. The purpose of this inspection is to follow up on lead testing results that exceeded 5.5 ppb.

LPA toured the facility and reviewed documents. The facility has taped off the water fountain located in the middle building near the 3's room, and LPA verified by inspecting the location.

See 809-D for deficiency being cited today.

An exit interview was conducted with Mrs. Cardenas and a copy of the report and appeal rights were provided. A notice of Site visit was given to Licensee, and Licensee was reminded that it needs to be posted for 30 days

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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 04/27/2023 03:33 PM - It Cannot Be Edited

Created By: Tasha Hackett-Alexander On 04/27/2023 at 02:28 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: WOOD ROSE ACADEMY AND PRESCHOOL	FACILITY NUMBER: 073406683
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/27/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/29/2023 Section Cited CCR 101700.3(b)(1)	1 2 3 4 5 6 7	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 This requirement has not been met as evidenced by record review. The licensee did not comply with the section cited above which poses a potential Health and Safety risk to persons in care.	1 2 3 4 5 6 7	THE FACILITY HAS TAPED OFF THE WATER FOUNTAIN TO PREVENT ACCESS TO CHILDREN IN CARE. THE FACILITY IS IN THE PROCESS OF REPLACING THE WATER FOUNTAIN. LICENSEE WILL SUBMIT PROOF OF REPLACEMENT BY 5/29/23
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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:

Loretta Dyson

LICENSING EVALUATOR NAME:

Tasha Hackett-Alexander

LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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