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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840745
Report Date: 10/26/2022
Date Signed: 10/26/2022 03:07:14 PM

Document Has Been Signed on 10/26/2022 03:07 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:FSA-OLIVEWOOD CDCFACILITY NUMBER:
334840745
ADMINISTRATOR:LACY HUGHESFACILITY TYPE:
850
ADDRESS:23268 OLIVEWOOD PLAZA DR.TELEPHONE:
(951) 924-6100
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 47DATE:
10/26/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lacy Hughes-DirectorTIME COMPLETED:
03:30 PM
NARRATIVE
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On October 26, 2022 at 1:00 PM, Licensing Program Analyst (LPA) Andrea Taylor conducted a Case Management visit in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPA Taylor met with Lacy Hughes Site Director (SD) who was informed of the reason for the visit.

Assembly Bill 2370, Chapter 676, Statutes of 2018, added Health and Safety Code section 1597.16 requiring all licensed Child Care Centers constructed before January 1, 2010, test their water for lead between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first lead testing.

During the visit, LPA Taylor toured the facility and observed the 2 drinking fountains identified as having high levels of lead. The drinking fountains are located on the North side of the building where the children do not play. LPA observed the fountains to have dust and completely dry indicating they have not been used. The fountains will be blocked so they cannot be used. The staff told LPA that the fountains have not been used by anyone since the facility was licensed.

Interviews with staff revealed the fountains are not used for staff or children for any reason. The children are provided water from jugs and paper cups.

The sink in classroom 5 is used for hand washing only. It should not have been tested as it is not used for food preparation or drinking water.
There was sample result on the report which is not one of the identified fixtures actually tested. It is unknown to what result this fixture applies.

An exit interview was conducted with SD. A copy of this report, appeal rights and a Notice of Site Visit was issued.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Andrea Taylor
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
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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