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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330910505
Report Date: 02/01/2023
Date Signed: 02/01/2023 11:17:00 AM

Document Has Been Signed on 02/01/2023 11:17 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
330910505
ADMINISTRATOR:JESSICA BAYERFACILITY TYPE:
850
ADDRESS:14700 PERRIS BLVD.TELEPHONE:
(951) 242-0707
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 73TOTAL ENROLLED CHILDREN: 73CENSUS: 48DATE:
02/01/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Jessica BayerTIME COMPLETED:
11:41 AM
NARRATIVE
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On February 1, 2023, at 10:43 AM, Licensing Program Analyst (LPA) Anastasia Flores, made an unannounced Case Management inspection, for reported Lead Exceedance. LPA met with Director, Jessica Bayer and proceeded to tour the facility with staff Stephanie Acosta. Also present in the facility were 48 daycare children and 8 teachers/staff. Facility was within ratio & capacity. On 10/26/22, LPA Andrea Taylor interviewed the director, staff and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and plan of correction via email on 12/22/22. The required signed and dated forms (LIC 9275/9276) were submitted to Community Care Licensing via email on 9/22/22.

Label A: Faucets and drinking fountains reported with 7.700 ppb or greater lead exceedance levels were as follows:

1 drinking fountain identified as having high levels of lead. The drinking fountain was located next to a storage cabinet in the Pre-K class. The fountain has been permanently removed. On 10/26/22, LPA Taylor was informed that the fountain has not been used by anyone and has been turned off and placed out of service until the plumber could come and replace the fountain. Children are bring their own water bottles daily to the facility.

Based on records review and information received, and current policies and procedures for the Department, the facility is being cited for having a lead exceedance in water fountain labeled letter A, under the Written Directives, Section 101700.3 (b) (1) California Lead Action Level at Child Care Centers. This poses a potential health, safety, or personal rights risk to the children in care.

An exit interview was conducted, a copy of this report, 809D and appeal rights were handed to facility Director, Jessica Bayer. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2023
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 02/01/2023 11:17 AM - It Cannot Be Edited


Created By: Anastasia Flores On 02/01/2023 at 10:58 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 330910505

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

101700.3(b)(1)

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Section 101700.3 (b) (1) California Lead Action Level at Child Care Centers 101700.3 (b) (1) 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 evidence by:
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On 11/21/22 the faucet was removed from the facility and is no longer accessible to children in care. LPA Flores received photos via email and also observed during inspection on 2/01/23.
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Based on records review and interviews, facility tested over the Action Level Exceedance, in one drinking fountain located next to the storage cabinet in the Pre-K class, labeled letter A, which is used for food preparation. This poses a potential health, safety, or personal rights risk to the 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:Pauline Beschorner
LICENSING EVALUATOR NAME:Anastasia Flores
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2023


LIC809 (FAS) - (06/04)
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