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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009825
Report Date: 12/21/2022
Date Signed: 12/21/2022 03:25:01 PM

Document Has Been Signed on 12/21/2022 03:25 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NAPA VALLEY COLLEGE CHILD & FAMILY P/S BY NCOEFACILITY NUMBER:
283009825
ADMINISTRATOR:DE LA CRUZ, MAYRAFACILITY TYPE:
850
ADDRESS:2277 NAPA VALLEJO HWY BLD 3000TELEPHONE:
(707) 256-7040
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 68TOTAL ENROLLED CHILDREN: 32CENSUS: 14DATE:
12/21/2022
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Mayra De La CruzTIME COMPLETED:
03:01 PM
NARRATIVE
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On 12/21/2022, Licensing Program Analyst (LPA), Y.Yang made a case management inspection and met with Center Director Mayra De La Cruz. The inspection was made in response to water lead testing results received from the California State Water Resource Control Board. The test results showed that the following faucets tested above the allowable level (5.0 ppb) of lead in the water: Sample sites, "C" and "E", located in the "Kitchen", had a reading of 54.0ppb and 7.1ppb, respectively. All other sources of water that were tested had a reading below the allowable level of 5.0ppb.

The facility temporarily removed the faucets from service by turning off the water supply, taping up the sink, and/or by posting a sign by the faucets. The center director notified all staff members regarding the faucet and instructed staff to not use the faucets. Children in care are receiving drinking water from other drinking fountains located at the center.

The Center Director submitted the External Water Sampling Self-Certification Form (LIC 9275), Child Care Center Sampling Checklist Form (LIC 9276) and Facility Sketch/Floor Plan (LIC 999) to LPA.

The following deficiency is being cited (see LIC 809D). Appeal Rights were provided. 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.

Exit interview conducted and report was reviewed with the Center Director, Mayra De La Cruz.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2022
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 12/21/2022 03:25 PM - It Cannot Be Edited


Created By: Yang Yang On 12/21/2022 at 03:02 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: NAPA VALLEY COLLEGE CHILD & FAMILY P/S BY NCOE
FACILITY NUMBER: 283009825

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/23/2023
Section Cited
CCR
101238(a)

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Buildings and Grounds 101238(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 evidenced by:
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The center director has made the faucets temporarily inaccessible by shutting the water off, taping up the sinks, and posting "do not use" signs. Children will be provided drinking water drinking fountains located at the center. The Center Director stated that the faucet at "Site C" and "Site E" have been replaced and will be retested on 12/22/22.The Center Director stated that she will submit the retesting documents within 2 weeks of the completed sampling to CCLD.
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Based on record review, the facility had two faucets "Site C" and "Site E" that exceeded that allowable levels of lead in the water (54 ppb and 7.1ppb, respectively). This poses a potential health and safety risk to 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:Alexis Hollon
LICENSING EVALUATOR NAME:Yang Yang
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2022


LIC809 (FAS) - (06/04)
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