<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203808295
Report Date: 01/19/2023
Date Signed: 01/19/2023 12:10:58 PM

Document Has Been Signed on 01/19/2023 12:10 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:OAKHURST LUTHERAN CHURCHFACILITY NUMBER:
203808295
ADMINISTRATOR:AIMEE ORCUTTFACILITY TYPE:
850
ADDRESS:39255 BLACK ROADTELEPHONE:
(559) 683-4673
CITY:OAKHURSTSTATE: CAZIP CODE:
93644
CAPACITY: 21TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
01/19/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Aimee OrcuttTIME COMPLETED:
12:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 01/19/2023, Licensing Program Analyst (LPA) Jeovanna Yanez conducted an unannounced case management inspection. LPA met with Director, Aimee Orcutt, for the purpose of conducting a case management inspection regarding a violation of Health and Safety Code Section 1597.16(a)(1) in accordance with Assembly Bill (AB) 2370.

Lead is a toxic metal that can be harmful and unhealthy for humans. Lead is odorless, colorless, and tasteless. Water lead testing was implemented to ensure there is safe water for consumption at Child Care Centers. Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010, have their drinking water tested for lead and post the results by January 1, 2023 and every 5 years after the date of the initial test.

As of this date, the facility has not provided Community Care Licensing (CCL) with evidence of lead testing being completed on water used for drinking or food preparation as required, therefore the facility is out of compliance.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809-D). Licensee was provided a copy of their appeal rights.

Exit interview conducted and report was reviewed with facility representative, Aimee Orcutt. This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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 01/19/2023 12:10 PM - It Cannot Be Edited


Created By: Jeovanna Yanez On 01/19/2023 at 11:01 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: OAKHURST LUTHERAN CHURCH
FACILITY NUMBER: 203808295

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2023
Section Cited
HSC
1597.16(a)(1)

1
2
3
4
5
6
7
(a) (1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023 and every five years after
1
2
3
4
5
6
7
Director agrees to schedule and complete lead testing on water used for drinking and food preparation. In addition, Director will submit copies of the following documents within 2 weeks of the completed sampling date:
(1) Completed External Water Sampler
  
8
9
10
11
12
13
14
the date of the initial test. This requirement was not met at evidenced by: Based on interview, the facility has not completed lead testing on water used for drinking or food preparation as required, which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Self-Certification Form (LIC 9275).
(2) Facility Sketch (LIC 999) fully labeled with the locations of all water outlets, including outlets that will not be sampled.
(3) Completed Child Care Center Sampling Checklist Form (LIC 9276). All documentation to be submitted by POC due date.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Rene Mancinas
LICENSING EVALUATOR NAME:Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/19/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2