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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416992
Report Date: 10/19/2022
Date Signed: 10/19/2022 12:37:04 PM

Document Has Been Signed on 10/19/2022 12:37 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:OROM CHILDREN'S CENTERFACILITY NUMBER:
274416992
ADMINISTRATOR:CANDACE FRAZUREFACILITY TYPE:
850
ADDRESS:1752 EAST ALISAL STREETTELEPHONE:
(831) 586-6766
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY: 51TOTAL ENROLLED CHILDREN: 51CENSUS: 8DATE:
10/19/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Candace Frazure TIME COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analyst (LPA), Elizabeth Larios, conducted an unannounced Case Management inspection. LPA met with Director, Candace Frazure, and explained the purpose of the inspection. LPA reviewed water sample summary and requested Candace to identify faucets U, Q, S, V, M, R, P, and O with reported Lead Action Level Exceedance of 5.5 parts per billion (ppb) or greater. LPA observed that faucets O, P, and M are located in classroom 5 (Scavengers), faucet S is located in classroom 6 (Investigators), and faucets U, V, Q, and R are located in classroom 7 (Creators). LPA observed a new fixture flushing tracking sheet above each faucet that have the instruction for staff to flush fixture for at least 30 seconds, 4 times a day, for at least 3 weeks until 10/25/2022. LPA observed sink faucets are being used for hand washing only. Director states children are provided gallon water to refill their individual cups.

LPA obtained the following facility documents during today's inspection: Self-Certification (LIC9275) completed by Certified External Water Sampler, Sampling Checklist Form (LIC9276), and Facility Sketch (LIC999) labeled with locations of water outlets that were tested.

The water sample conducted by Adviro on 06/11/22 indicated the following:

1) Faucet "O-Sink Faucet Classroom 5" has Lead Action Level Exceedance value of 20
ppb.

2) Faucet "P-Sink Faucet Classroom 5" has Lead Action Level Exceedance value of 7.4 ppb.
====CONTINUATION OF LIC 809 DATED 10/19/2022 PAGE 2====
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: OROM CHILDREN'S CENTER
FACILITY NUMBER: 274416992
VISIT DATE: 10/19/2022
NARRATIVE
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====CONTINUATION OF LIC 809 DATED 10/19/2022 PAGE 1====

3) Faucet "M-Sink Faucet Classroom 5" has Lead Action Level Exceedance value of 8.7 ppb.

4) Faucet "S-Sink Faucet Classroom 6" has Lead Action Level Exceedance value of 11
ppb.

5) Faucet "U-Sink Faucet Classroom 7" has Lead Action Level Exceedance value of 12 ppb.

6) Faucet "V-Sink Faucet Classroom 7" has Lead Action Level Exceedance value of 21
ppb.

7) Faucet "Q-Sink Faucet Classroom 7" has Lead Action Level Exceedance value of 11 ppb.

8) Faucet "R-Sink Faucet Classroom 7" has Lead Action Level Exceedance value of 7.6 ppb.

As a result of this inspection, Type B deficiency was cited on the following page.

Exit interview conducted and report was reviewed with Director, Candace Frazure.



A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/19/2022 12:37 PM - It Cannot Be Edited


Created By: Elizabeth Larios On 10/19/2022 at 12:09 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: OROM CHILDREN'S CENTER
FACILITY NUMBER: 274416992

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/21/2022
Section Cited

101700.3(b)(1)

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Lead Testing Written Directives - 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 a new fixture flushing tracking sheet above each faucet that have the instruction for staff to flush fixture for at least 30 seconds, 4 times a day, for at least 3 weeks until 10/25/2022. LPA observed sink faucets are being used for hand washing only. Director states children are provided gallon water to refill their individual cups.
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Based on record review, the Lead Sampling Report in eight (8) identified faucets: U,Q,S,V,M, R,P, and O had elevated lead above 5.5 ppb. This poses a potential risk to the health, safety, or personal rights of children in care.
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The facility to submit a new water
sample test results to Licensing that is within the reporting limits by 11/21/22.

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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:Joel Segura
LICENSING EVALUATOR NAME:Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


LIC809 (FAS) - (06/04)
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