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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810283
Report Date: 12/19/2024
Date Signed: 12/19/2024 11:41:58 AM

Document Has Been Signed on 12/19/2024 11:41 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FUSD-AYERFACILITY NUMBER:
103810283
ADMINISTRATOR/
DIRECTOR:		BECKWITH, KIMFACILITY TYPE:
860
ADDRESS:5272 E LOWE AVETELEPHONE:
(559) 253-6400
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
12/19/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Charlotte MirandaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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On 12/19/2024 Licensing Program Analysts (LPAs), Valentin Hernandez and Valerie Mireles conducted an unannounced case management inspection. LPAs met with Director, Charlotte Miranda. The purpose of today's inspection is to conduct a Case Management Inspection regarding a lead exceedance referred to, as an Action Level Exceedance (ALE) of over 5.5 parts per billion (bbp) in the water at this facility.

Fresno Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test that was conducted on 11/06/2024. Based on records reviewed from LA Testing and discussions with Charlotte Miranda it has been determined there is an exceedance to outlet 103810283 A in the facility. LPAs inspected outlet 103810283 A, and it was observed to be a water bubbler in preschool classroom that was impacted with a test result of 10.0 ppb (ALE) 0f lead. Director Charlotte Miranda has discontinued the use of the exceeding outlet by making the outlet inaccessible by taping it sealed. They have have installed a water filter and will be retested prior to use. (See Plan of Corrections for further corrective actions on LIC809-D). Charlotte Miranda has notified authorized representatives of this correction in (both languages English and Spanish).

Facility will continue to provide water to children in care from school cafeteria which has a water filter in place.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, a Type B deficiency is being cited: (see next page, LIC 809-D). Charlotte Miranda, was provided a copy of appeals rights. An exit interview was conducted with, Charlotte Miranda.

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: Valentin Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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 12/19/2024 11:41 AM - It Cannot Be Edited


Created By: Valentin Hernandez On 12/19/2024 at 10:58 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: FUSD-AYER
FACILITY NUMBER: 103810283

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/19/2024
Section Cited

101700.3

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101700.3 California Lead Action Level at Child Care Centers (a) California's Action Leve 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..., before comparing to the Action Level. (1) A result with values of 5.5 ppb... Action Level
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LPAs oberved the outlet 103810283 A has been made inaccessible by taping it sealed. Director Charlotte Miranda confirms the results will be sent in by POC 1/17/2025. Director Charlotte Miranda confirmed facility uses water from school cafeteria which has a water filter in place.
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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 evidence by based on record review provided by LA testing result of 10.00 (ALE) for outlet 103810283 A. Which is out of compliance over the allowable ALE 5 ppb. 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:Valentin Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


LIC809 (FAS) - (06/04)
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