<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840454
Report Date: 03/07/2024
Date Signed: 03/07/2024 02:39:06 PM

Document Has Been Signed on 03/07/2024 02:39 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:VVUSD EL POTRERO PRESCHOOLFACILITY NUMBER:
334840454
ADMINISTRATOR:ANDREA RODICH-VITECKFACILITY TYPE:
850
ADDRESS:16820 VIA PAMPLONA DRIVETELEPHONE:
(951) 940-8530
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92551
CAPACITY: 390TOTAL ENROLLED CHILDREN: 390CENSUS: 89DATE:
03/07/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Rosaura NavarroTIME COMPLETED:
02:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 3/7/24 at 1:35 PM, Licensing Program Analysts (LPAs) Sumayya Habeebulla, Amber Shaw and Kelli Waters, conducted a Case Management visit in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPAs met with Facility Representative Rosaura Navarro who was informed of the reason for the visit.

Assembly Bill 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers constructed before January 1, 2010, to test their drinking and cooking water for lead contamination between January 1, 2020, and January 1, 2023, and then every 5 years after the date of the first lead testing. LPA observed on the report provided by the SWRCB the FAUCET located in Room #22 identified as having high levels of lead.

The faucet is located in classroom #22 and the classroom is currently used for Speech Pathology Office. Children are not using the classroom. As per Facility Representative Rosaura Navarro the faucet located in the classroom was tested above the permitted level. The facility retested the faucet, and the results still came out above the permitted level. Facility replaced the faucet and the water lines as a plan of correction. Facility will conduct retesting for the sink. Facility Representative will submit the scheduled dates for testing to the department as soon as it is available. Once results are received, to notify the department.

See LIC 809D for cited deficiency in accordance with the Health and Safety Code.

An exit interview was conducted with the Facility Representative Rosaura Navarro. A copy of this report, appeal rights and a Notice of Site Visit was issued.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Amber Shaw
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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 03/07/2024 02:39 PM - It Cannot Be Edited


Created By: Amber Shaw On 03/07/2024 at 02:20 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: VVUSD EL POTRERO PRESCHOOL
FACILITY NUMBER: 334840454

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/08/2024
Section Cited
HSC
1597.16(a)(1)

1
2
3
4
5
6
7
Health and Safety1597.16(a)(1) A licensed child day care center, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

1
2
3
4
5
6
7
Retesting will be conducted. Facility representative agrees to submit the schedule for the retesting and the results once obtained.
8
9
10
11
12
13
14
This requirement was not met as evidenced by:
Testing was completed on 02/03/2024, A level of 5.8 was tested as an exceedance in Room 22 Sink.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Carlos Martinez
LICENSING EVALUATOR NAME:Amber Shaw
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2