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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801986
Report Date: 01/17/2023
Date Signed: 01/17/2023 12:47:47 PM

Document Has Been Signed on 01/17/2023 12:47 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:GREENFIELD CHILDREN'S CENTERFACILITY NUMBER:
153801986
ADMINISTRATOR:SHARON PHILLIPSFACILITY TYPE:
850
ADDRESS:5400 MONITORTELEPHONE:
(661) 831-1398
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
01/17/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Kimberly ReedyTIME COMPLETED:
01:00 PM
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On 1/17/23, Licensing Program Analyst (LPA) Kathy Pacheco and LPA Denisia Jimenez conducted an unannounced case management inspection at the facility. LPAs met with Director Kimberly Reedy to discuss the results of the lead testing of the water at the facility.

Based on information obtained from the water lead sampling test conducted by YES Environmental, Inc., it was determined there was an Action Level Exceedance (ALE), meaning there was a result with values of 5.5 ppb or greater. The ALE of 19 ppb was discovered in water source (B) located in MS-MPR kitchen-stove and 18.5 ppb was discovered in water source (A) located in MS-MPR kitchen-skillet. Director stated both water source locations are located off-site at Greenfield Middle School in the multi-purpose room/kitchen. Director stated the meals for Greenfield Children's Center are prepared at Greenfield Middle School in the multi-purpose room/kitchen, however, water source (A) and (B) have never been used to prepare the Center's meals and those water sources will continue to not be used.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations, 101700.3 (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 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:
The following deficiency was cited: (see next page titled 809-D)

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Kimberly Reedy.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 12/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/29/2022
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 01/17/2023 12:47 PM - It Cannot Be Edited


Created By: Kathy Pacheco On 01/17/2023 at 12:23 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: GREENFIELD CHILDREN'S CENTER
FACILITY NUMBER: 153801986

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/14/2023
Section Cited

101700.3(c)

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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. This requirement was not met as evidenced by results from the water lead sampling test showing an ALE of 19 ppb in
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Director stated water sources (A) and (B) are located off-site and have never been used to prepare the meals for Greenfield Children's Center. Director is in the process of determining the action to be taken for the water sources since they are located off-site.
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water source (B) and and ALE of 18.5 in water source (A). This poses a potential risk to the health, safey, and/or personal rights of children 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:Kathy Pacheco
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023


LIC809 (FAS) - (06/04)
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