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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801609
Report Date: 10/21/2022
Date Signed: 10/21/2022 11:36:39 AM

Document Has Been Signed on 10/21/2022 11:36 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LITTLE RED SCHOOL HOUSE #3FACILITY NUMBER:
153801609
ADMINISTRATOR:LYTVYNENKO, AMBERFACILITY TYPE:
850
ADDRESS:4601 FRUITVALE AVE.TELEPHONE:
(661) 588-2227
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 67TOTAL ENROLLED CHILDREN: 67CENSUS: 59DATE:
10/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Amber LytvynenkoTIME COMPLETED:
11:45 AM
NARRATIVE
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On October 21, 2022 Licensing Program Analyst (LPA) Kari McWilliams conducted an unannounced case management inspection. LPA McWilliams met with Director Amber Lytvyenko. 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. LPA 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 CA Rural Water Association and discussions with Director Lytvynenko it has been determined that there is an exceedance to outlet (G) in the facility. LPA McWilliams inspected outlet (G) it was observed to be an outside water fountain (1 of 1) that was impacted with 15.0 ppb(ALE) of lead. Director Lytvynenko, has discontinued the use of water fountain by; immediately blocking off the use of the water fountain. Director Lytvynenko is permanently capping off the fountain and re-purposing the stone planter to a succulent garden.

(See plan of correction for further corrective action 809D). Director Lytvynenko 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 Lytvynenko was provided a copy of the appeal rights. An exit interview was conducted with Director Lytvynenko.

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: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2022
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 10/21/2022 11:36 AM - It Cannot Be Edited


Created By: Kari McWilliams On 10/21/2022 at 10:56 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: LITTLE RED SCHOOL HOUSE #3
FACILITY NUMBER: 153801609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2022
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 5ppb....(c) If testing indicates an Action Level Exceedance at any water outlet, the water from that 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 immediately blocked off water oultet G and made it inaccessible to children in care.
Director is capping off the water outlet permanently and re-purposing the stone planter.
Director will immediately notify all guardians/parents of the exceedance through email in language of preference of the exceedance and the plan of correction.
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Based on record review provided by CA Rural Water Association a result of (ALE) of 15 for outlet G 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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Director will provide video/pictures of the re-purposed fountain when complete by above POC date.

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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: 10/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/21/2022


LIC809 (FAS) - (06/04)
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