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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100404278
Report Date: 01/26/2023
Date Signed: 01/26/2023 11:06:27 AM

Document Has Been Signed on 01/26/2023 11:06 AM - 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FRESNO EOC HURON HEAD STARTFACILITY NUMBER:
100404278
ADMINISTRATOR:HERNANDEZ, SAMANTHAFACILITY TYPE:
850
ADDRESS:16641 PALMER STREETTELEPHONE:
(559) 263-1205
CITY:HURONSTATE: CAZIP CODE:
93234
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 26DATE:
01/26/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Samantha Hernandez, DirectorTIME COMPLETED:
11:15 AM
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On 01/26/23 Licensing Program Analyst (LPA) Priscilla Zamudio conducted an unannounced case management inspection. LPA met with Samantha Hernandez, Director, for the purpose of conducting a case management inspection, regarding 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.

Fresno Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from the Environmental Laboratory Accreditation Program (ELAP) report and self reported information for Huron EOC Headstart, impacted with an(ALE of 8.5 ppb in Outlet G-Children’s Faucet) and (ALE of 5.5 ppb in Outlet C-Children’s Faucet). These results indicate out of compliance over (ALE) 5.5 ppb. (See Plan of correction for further corrective action 809D). Outlets have temporarily been made inoperable and have been replaced. Director agrees to continue with the resampling process for an action level result of under 5.5 ppb for compliance with a Certified Sampler. Director is providing water to the children by means of a water dispenser service from a third party. Potable water is also made available to visitors and staff during hours of operation.

Parents or authorized representatives have been notified of the (ALE ) Per PIN 20-20 CCP WD 101704 (b)(3). Facility also posted results for parents or authorized representatives to review Per PIN 20-20 CCP WD 101703 (b).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited:
(see next page, 809 D). Director was provided a copy of appeal rights and an exit interview was conducted. 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: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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 01/26/2023 11:06 AM - It Cannot Be Edited


Created By: Priscilla Zamudio On 01/26/2023 at 10:45 AM
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: FRESNO EOC HURON HEAD START
FACILITY NUMBER: 100404278

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2023
Section Cited

101700.3

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California Lead Action Level at Child Care Centers (a) California’s Action Level for lead in water at Child Care Centers is 5 ppb. (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. (c) If testing indicates an Action Level Exceedance at any water outlet, the water from that outlet is deemed not safe to drink and an immediate response pursuant to section 101704 shall be required. This requirement was not met as evidenced by:
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Director has notified and posted ALE results at a reasonable location for Authorized representatives to review. Director provided evidence of the repaired new fixtures for(ALE of 8.5 ppb in outlet G-Children's faucet) and impacted with an (ALE of 5.5 ppb in outlet C-Children's faucet). Director will provide evidence of testing results at or below the action level by POC date 2/27/23.

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Based on record review provided by Licensee indicating (ALE of 8.5 ppb in outlet G-Children's faucet) and impacted with an (ALE of 5.5 ppb in outlet C-Children's faucet). These results indicate out of compliance over (ALE) 5.5 ppb, which is out of compliance. This poses a potential health, safety or personal rights 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:Cynthia Brannon
LICENSING EVALUATOR NAME:Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023


LIC809 (FAS) - (06/04)
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