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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274404864
Report Date: 09/07/2023
Date Signed: 09/07/2023 09:27:25 AM

Document Has Been Signed on 09/07/2023 09:27 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:JESSE G. SANCHEZ PRESCHOOLFACILITY NUMBER:
274404864
ADMINISTRATOR:MONICA CANO-RAYASFACILITY TYPE:
850
ADDRESS:901 NORTH SANBORN ROADTELEPHONE:
(831) 753-5760
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY: 24TOTAL ENROLLED CHILDREN: 17CENSUS: 15DATE:
09/07/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lourdes LizarragaTIME COMPLETED:
09:35 AM
NARRATIVE
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced case management inspection to discuss the lead water testing and Action Level Exceedance (ALE) for one water outlet within the Facility. LPA met with Lourdes Lizarraga, lead teacher, and explained purpose of today's inspection to her.

The lead testing was completed by Central Coast Water Operations on August, 2023. An Action Exceedance Level is a value of 5.5 parts per billion or greater. One water outlet (water fountain) - Fixture B (Inside classroom #4 of the Sanchez Elementary School campus) reported an ALE of 6 parts per billion.

LPA observed the water outlet has been removed from service, and Ms. Lizarraga stated drinking water for children and staff is being provided only from water bottles. Gabriela Moran from Maintenance, Operations, Transportation, and Safety Department via email stated the Facility is in the process of getting the outlet retested.

The Self-Certification form (LIC 9275), Sampling Checklist form (LIC 9276) and updated Facility Sketch (LIC 999) were provided to LPA Campos prior to today's inspection.

Exit interview conducted and report was reviewed with Lead Teacher Lizarraga. The following Type B deficiency is cited on the attached page (LIC 809-D). Failure to comply with the Plan Of Corrections (POC) by the due date on LIC809D shall result in an immediate civil penalty of $100 per day per each deficiency.

Copy of appeal rights was provided to Ms. Lizarraga prior to the conclusion of today's inspection.

Notice of site visit was issued and must remain posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2023
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 09/07/2023 09:27 AM - It Cannot Be Edited


Created By: Fermin Campos-Jaramillo On 09/07/2023 at 09:01 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: JESSE G. SANCHEZ PRESCHOOL
FACILITY NUMBER: 274404864

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/06/2023
Section Cited

101700.3(b)(1)

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Lead Testing Written Directives (b)(1) a result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement was not met as evidenced by:
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LPA observed the water outlet has been removed from service and Ms. Lizarraga stated drinking water for children and staff is being provided only from water bottles.
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Fixture B, drinking water fountain inside classroom 4, reported an ALE of 6 parts per billion.
This poses a potential risk to the health, safety, and personal rights of children in care.
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Facility is in the process of getting the outlet retested. Ms. Lizarraga will make sure to submit results of follow up lead re-testing to LPA by 10/06/23.

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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:Mary Segura
LICENSING EVALUATOR NAME:Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/07/2023


LIC809 (FAS) - (06/04)
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