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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243801675
Report Date: 08/25/2022
Date Signed: 08/25/2022 12:29:02 PM

Document Has Been Signed on 08/25/2022 12:29 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:CCCDS - GRANADA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
243801675
ADMINISTRATOR:GAVINA, TANIAFACILITY TYPE:
850
ADDRESS:9732 E HASKELLTELEPHONE:
(209) 382-1042
CITY:PLANADASTATE: CAZIP CODE:
95365
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 8DATE:
08/25/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Claudia Villatoro TIME COMPLETED:
12:35 PM
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On 08/25/22 Licensing Program Analyst (LPA) Araceli Gibson conducted an unannounced case management inspection. LPA Gibson met with Claudia Villatoro, Nutrition Services Coordinator and Tania Gavina Santoyo, Site Supervisor. Purpose of today's inspection is to conduct a case management inspection, and to notify them there has been a lead exceedance referred to as a Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

Fresno Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based records reviewed from Pace Analytical with Claudia Villatoro, Nutrition Services Coordinator and Tania Gavina Santoyo, Site Supervisor LPA Gibson inspected outlet (B) in the (preschool classroom 1 side 2) that was impacted with 8.3 ppb (ALE) of lead. Site Supervisor has disconnected water outlet (B) until repairs can be made. Potable water is available to preschool children in that classroom by outlet (A) located in classroom 1A. An IGLOO with water from a potable source and cups are available to preschool children during day care hours. Claudia Villatoro has agreed to repair and retest the impacted outlet. Claudia agrees to submit evidence of the outlet testing under 5.5 ppb action level. 101238(a) Buildings and Grounds citation was issued with a plan of correction in place to ensure the safety and well being of children, employees and visitors. (See Plan of correction for further corrective action 809D). Site Supervisor has agreed to notify 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, 809 D). Claudia Villatorro was provided a copy of appeal rights. An exit interview was conducted.

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: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2022
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 08/25/2022 12:29 PM - It Cannot Be Edited


Created By: Araceli Gibson On 08/25/2022 at 12:10 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: CCCDS - GRANADA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 243801675

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2022
Section Cited
CCR
101238(a)

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101238(a) Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidence by:
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Site Super agrees to notify authorized representatives in both languages English and Spanish. Claudia Villatoro has agreed to repair and retest the impacted outlet. Claudia agrees to submit evidence of the outlet testing under 5.5 ppb action level. By POC date.
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Based records reviewed from Pace Analytical outlet (B) in the (preschool classroom 1 side 2) that was impacted with 8.3 ppb (ALE) of lead. Site Supervisor has disconnected water outlet (B) as it has tested over the 5.5 ppb over the allowalble action level.
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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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Araceli Gibson
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2022


LIC809 (FAS) - (06/04)
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