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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409309
Report Date: 02/08/2023
Date Signed: 02/08/2023 03:40:49 PM

Document Has Been Signed on 02/08/2023 03:40 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:LANCASTER-JOSHUA ELEMENTARY STATE PRESCHOOLFACILITY NUMBER:
197409309
ADMINISTRATOR:FOUNTAIN, KELLYFACILITY TYPE:
850
ADDRESS:43926 NO. 2ND STREET EASTTELEPHONE:
(661) 726-9717
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 19DATE:
02/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:ECE Coordinator Christy DepasqualeTIME COMPLETED:
03:50 PM
NARRATIVE
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On 02/08/2023 Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced case management inspection. LPA Del Mundo met with Early Childhood Education (ECE) Coordinator Christy Depasquale. The purpose of today's inspection is to conduct a case management inspection, and to notify them there has been a lead exceedance referred for an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

Palmdale Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. LPA Del Mundo observed that the water fountain located outside the preschool room (Area C) has an ALE of 11.00. However, it is covered and is inaccessible to preschool children. There are 19 preschool children present during the time of inspection. Currently, the preschool is using water cooler (Igloo) and disposable paper cups for preschool children. ECE Coordinator stated that they believed the fountain tested positive because it has not being used prior to Covid 19 pandemic. The fountain is in the process of re-flushing for three times a week (30 seconds, 4 times a day) and have it retested for lead exceedance after the flushing is completed on the third week. No repairs was made until the it has been retested.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, a type B deficiency is being cited (see next page, 809 D). ECE Coordinator Christy Depasquale was provided a copy of the appeal rights. An exit interview was conducted with ECE Coordinator Christy Depasquale.

This report shall be made available to the public upon request. The Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE: DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/08/2023
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 02/08/2023 03:40 PM - It Cannot Be Edited


Created By: Joselito DelMundo On 02/08/2023 at 03:16 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LANCASTER-JOSHUA ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 197409309

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/08/2023
Section Cited

101700.3

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101700.3 California Lead Action Level at Child Care Centers (a) California’s Action Level for lead in water at Child Care Centers is 5 ppb. (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.
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School District facility is currently conducting flushing of outlet (Area C) for 30 seconds, 4 times in a day until the third week. Water cooler and disposables cups will be provided to preschool children. Outlet (Area C) will be retested after the third week. Results will be provided to LPA Del Mundo thru email.
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This requirement was not met as evidence by: based on the information received from outlet (Area C) is an outdoor fountain that has an ALE of 11 ppb, which is out of compliance with the allowable ALE of 5.5 ppb. This poses a potential health and safety risk for the 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:Lady King
LICENSING EVALUATOR NAME:Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023


LIC809 (FAS) - (06/04)
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