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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150407404
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:50:06 PM

Document Has Been Signed on 01/12/2023 01:50 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:NORTH BEARDSLEY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
150407404
ADMINISTRATOR:DOMINGUEZ-LOPEZ RAQUELFACILITY TYPE:
850
ADDRESS:900 SANFORD DRIVETELEPHONE:
(661) 399-9682
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 11DATE:
01/12/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Cindy DiazTIME COMPLETED:
02:15 PM
NARRATIVE
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On January 12, 2023 Licensing Program Analysts (LPAs) Kari McWilliams and Julie Baptista conducted an unannounced case management inspection. LPAs met with Facility Representative Cindy Diaz. The purpose of today’s inspection was to conduct a case management inspection and to notify the facility that there has been 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. LPAs conducted a tour of the facility inside and out and a census was taken.

Fresno South Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from Terraphase Engineering and discussions with Facility Representative Diaz it has been determined that there is an exceedance to outlet (E) in the facility.

LPA McWilliams inspected outlet E it was observed to be an type of source drinking fountain that was impacted with amount of lead ppb (ALE) of lead. Facility Representative Diaz, has discontinued the use of outlet E by removing the drinking fountain and capping it making it unusable
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(See plan of correction for further corrective action 809D). Facility Representative Diaz has notified authorized representatives of this corrective action in both languages; English and Spanish.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809D). Director were provided a copy of the appeal rights. An exit interview was conducted with Facility Representative Diaz.

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: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2023
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 01/12/2023 01:50 PM - It Cannot Be Edited


Created By: Kari McWilliams On 01/12/2023 at 01:22 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NORTH BEARDSLEY CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 150407404

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2023
Section Cited

101700.3

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(a)California’s Action Level for lead in water at Child Care Centers is 5ppb.(b) Testing results with fractional ppb readings of 0.5ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5ppb or greater shall be deemed an Action Level Exceedance.
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Facility represenative has informed all parents/guardians of children in care of the exeedance in Spanish and English; and has made the report accessible for them to read. Fountain E has been made inaccessible and is being permanently capped. The facility uses water bottles and have purchased fill stations for the classroom.
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This requirement was not met by evidence by: Based on record review provided by Terraphase Engineeringl a result of (ALE) of 5.9 for outlet E which is out of compliance over the allowable ALE 5.5ppb. 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:Luisa Gavoutian
LICENSING EVALUATOR NAME:Kari McWilliams
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


LIC809 (FAS) - (06/04)
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