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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808307
Report Date: 01/18/2023
Date Signed: 01/18/2023 02:58:29 PM


Document Has Been Signed on 01/18/2023 02:58 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:A GOOD TIME OUTFACILITY NUMBER:
153808307
ADMINISTRATOR:SHERMAN, MELANIE/KARENFACILITY TYPE:
850
ADDRESS:3400 CALLOWAY DRIVE, SUITE 501TELEPHONE:
(661) 410-8463
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:59CENSUS: 16DATE:
01/18/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Amy BennettTIME COMPLETED:
03:30 PM
NARRATIVE
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On 1/18/2023, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced case management inspection. LPA Marquez met with Director Amy Bennett who accompanied LPA on a tour of the facility, and a census was taken. The purpose of today's inspection is to address the lead exceedance, referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

The Fresno South Regional Office received notification of water lead exceedance at the facility resulting from a water lead sampling test collected on 12/17/2022. Records were reviewed from Enthalpy Analytical Laboratory dated 12/20/022, and it has been determined that there is an exceedance to outlet E (water bubbler) in the facility. LPA Marquez inspected outlet E which is located in the lunch area that was impacted with 7.0ppb (ALE) of lead. During this inspection, Bennett turned off the water valve to outlet E making it inoperable to preschool children. Bennett stated drinking water can still be obtained from outlet F which had a “none detected” level.

The facility will notify all authorized representatives of the ALE and of the corrective action. (See plan of correction for further corrective action, page LIC 809-D).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see page LIC 809-D). An exit interview was conducted with Amy Bennett. A copy of this report and a copy of the Appeals Rights was provided. 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.
SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023
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 01/18/2023 02:58 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: A GOOD TIME OUT
FACILITY NUMBER: 153808307

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2023
Section Cited

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CALIFORNIA ACTION LEVEL AT CHILD CARE CENTERS (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE). This requirement was not met as evidenced by record review.
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Per Director Bennett, authorized representatives will be notified of the lead exceedance and testing results. Outlet E was made inoperable during this inspection. Director stated they will retest and/or Appeal the citation and/or repair outlet E.
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One (labeled E) outlet, in the facility contained lead exceedance greater than 5.5 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: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023
LIC809 (FAS) - (06/04)
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