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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801239
Report Date: 11/02/2022
Date Signed: 11/02/2022 03:03:27 PM

Document Has Been Signed on 11/02/2022 03:03 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:NEW LIFE DISCOVERY SCHOOL (KEATS)FACILITY NUMBER:
103801239
ADMINISTRATOR:WILKINSON, BRANDYFACILITY TYPE:
850
ADDRESS:420 E. KEATSTELEPHONE:
(559) 222-8687
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY: 87TOTAL ENROLLED CHILDREN: 87CENSUS: 35DATE:
11/02/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Samantha Rodriguez TIME COMPLETED:
03:15 PM
NARRATIVE
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On 11/02/22 Licensing Program Manager (LPM) Juvenal Moctezuma and Licensing Program Analyst (LPA) Araceli Gibson conducted an unannounced case management inspection. LPA Gibson met with Samantha Rodriguez, 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 State Water Resources Control Board (SWRCB) and self reported information for Huggable preschool classroom water fountain/bubbler (outlet C) had a result of (ALE) of 41.00 ppb, which is out of compliance over (ALE) 5.5 ppb. This outlet impacts no other licenses. (See Plan of correction for further corrective action 809D). Facility replaced the water fountain and has covered the outlet to make inoperable, and is in the planning stages of repair with the Certified Sampler. Director agrees to continue with the resampling process for an action level result of under 5.5 ppb for compliance.

Director, Samantha Rodriguez is providing water to the preschool children in the Huggable classroom by means of water in a pitcher and cups from another potable source. Director agrees to have fresh potable water available to preschool children, visitors and staff during hours of operation. Parents are to be notified of the (ALE ) Per PIN 20-20 CCP WD 101704 (b)(3). Facility is also required to post results for parents 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. An exit interview was conducted with the Director. 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: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
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 11/02/2022 03:03 PM - It Cannot Be Edited


Created By: Araceli Gibson On 11/02/2022 at 11:55 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: NEW LIFE DISCOVERY SCHOOL (KEATS)
FACILITY NUMBER: 103801239

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2022
Section Cited

101700.3

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101700.3 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.
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Director agrees to notifiy and post ALE results at a reasonable location for Authorized representatives to review. Director agrees to submit required licensing forms LIC 999, LIC 9275 and LIC 9276. Director agrees to provide evidence of the repaired new fixture for (outlet C) and evidence of testing at or below the action level.
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This requirement was not met evidence by: Based on record review from State Water Resource Control Board (SWRB) and self reported information outlet C had a result of (ALE) of 41.00 ppb, which is out of compliance over Action Level. 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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Araceli Gibson
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2022


LIC809 (FAS) - (06/04)
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