<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808052
Report Date: 01/27/2023
Date Signed: 01/27/2023 06:59:02 PM

Document Has Been Signed on 01/27/2023 06:59 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:FRESNO EOC CEDARWOOD HEAD STARTFACILITY NUMBER:
103808052
ADMINISTRATOR:MARTINEZ, RACHELFACILITY TYPE:
850
ADDRESS:2063 S CEDARTELEPHONE:
(559) 263-1205
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 33DATE:
01/27/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rachel MartinezTIME COMPLETED:
11:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 01/27/2023 Licensing Program Analyst (LPA) Ka Vang conducted an unannounced case management inspection. LPA met with Facility Director Rachel Martinez 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. A toured of the facility was conducted and there are two classrooms inside the facility. Census was conducted; Classroom A has 18 children and Classroom B has 15 children.

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 Child Care Center Lead Sampling and Reporting Tool and self reported information to licensee # 103808052 that two outlets are impacted with an (ALE). Outlets are identified as followed: Outlet B adult faucet with an (ALE) of 6.1 ppb and Outlet C children’s fountain faucet with (ALE) of 5.7 ppb. Both outlets located inside the Administration Office.

This result indicates out of compliance over (ALE) 5.5 ppb. (See Plan of correction for further corrective action 809D). Outlets have been repaired and made inoperable and it is in the planning stages of re-testing their water. 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 stated children are provided water from a potable source in the kitchen by igloo and cups. Potable water is also made available to visitors and staff during hours of operation. Facility posted results for parents to review Per PIN 21-21-1 CCP WD 101703 (b). In addition, parents and guardians will be notify by letter and verbally of the (ALE) Per PIN 21-21-1 CCP WD 101704 (b)(3).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited during today’s inspection: (see next page, 809 D). Director was provided a copy of appeal rights. 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: Rene Mancinas
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2023
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 01/27/2023 06:59 PM - It Cannot Be Edited


Created By: Ka Vang On 01/27/2023 at 11:01 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 CEDARWOOD HEAD START
FACILITY NUMBER: 103808052

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

101700.3

1
2
3
4
5
6
7
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. Testing results with fractional ppb readings of less than 0.5 ppb shall be rounded down 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. (2) Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. (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.
1
2
3
4
5
6
7
Director submitted evidence of replacement on outlets B and C in the Administration Office. Director will provide evidence that outlets B and C test at or below Action Level by Plan of Correction (POC) due date 02/27/223. Director agrees to notified parents and guardians and posted (ALE) results at a reasonable location for Authorized Representatives to review as soon as possible.
8
9
10
11
12
13
14
This requirement was not met evidence by: Based on record review provided Child Care Center Lead Sampling and Reporting Tool and the Director's interview. Indicating (ALE) impacting 2 outlets identified as B and C located inside the Administration Office. These results are out of compliance over (ALE) 5.5 ppb, which poses a potential health, safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14

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:Rene Mancinas
LICENSING EVALUATOR NAME:Ka Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2