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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845346
Report Date: 12/28/2022
Date Signed: 12/28/2022 10:02:59 AM

Document Has Been Signed on 12/28/2022 10:02 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:DESERT PRESCHOOL ACADEMYFACILITY NUMBER:
334845346
ADMINISTRATOR:MARY VELASQUEZFACILITY TYPE:
830
ADDRESS:13095 INDIAN ST.TELEPHONE:
(951) 924-3636
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 5DATE:
12/28/2022
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Mary VelasquezTIME COMPLETED:
10:15 AM
NARRATIVE
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On December 28, 2022 at 8:20 am, Licensing Program Analyst (LPA) Lorena Valenzuela made an unannounced Case Management inspection, for the reported Lead Exceedance in the facility’s water. LPA met with Site Director, Mary Velasquez and proceeded to tour the facility. Also present in the facility were 5 daycare children and 3 teachers/staff. Facility was within ratio and capacity. All staff members have the required background clearances.

LPA interviewed the director and examined the water outlets deemed an Action Level Exceedance. Facility provided facility sketch with labeled water outlet locations and the required signed and dated forms (LIC 9275, LIC 9276) to Community Care Licensing via email on 11/17/2022.

Faucets reported with 5.5 ppb (parts per billion) or greater lead exceedance levels were as follows:

Sink located in infant sleep room- outlet labeled letter “E” 10.20 ppb

Sink located in changing room- outlet labeled letter “F” 13.80 ppb

All other fountains and water outlets tested within an acceptable level with no lead exceedance. Parents were notified via a letter given to parents and kept on file at the facility. The Site Director (SD) Mary Velasquez stated that outlet E and F have had the faucets replaced by the maintenance person on 12/14/2022. The SD stated that prior to 12/14/2022 the outlets were bagged and had a do not use sign. At the time of the inspection LPA Valenzuela observed water outlets E and F being were not bagged or covered otherwise, and there was no “do not use” sign to prevent the faucets from being used. Per the site director the facility will be retesting the water outlets E and F but date in unknown.

The site director states that drinking water is available throughout the facility. LPA observed the water outlet in infant room where infants eat to have a filter. The director states that staff will fill a water pitcher using the filtered water and provide to children throughout the day. Interviews with staff revealed staff only use the water with filter for children in care, per facility sketch this is the water outlet labeled "D".

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/28/2022
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DESERT PRESCHOOL ACADEMY
FACILITY NUMBER: 334845346
VISIT DATE: 12/28/2022
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Based on interview, 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 outlets labeled letter E and F, under the Written Directives, Section 101700.3 (b) (1) California Lead Action Level at Child Care Centers.

See LIC809D cited deficiency.

Exit interview conducted and report was reviewed with Site Director Mary Velasquez. A notice of site visit was given and must remain posted for 30 days. LPA observed Director Velasquez post notice of site visit.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/28/2022 10:02 AM - It Cannot Be Edited


Created By: Lorena Valenzuela On 12/28/2022 at 09:33 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: DESERT PRESCHOOL ACADEMY
FACILITY NUMBER: 334845346

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
01/27/2023
Section Cited

101700.3(b)(1)

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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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Site Director Velasquez agrees to provide the Department with test results of the upcoming water sample results and updates until water outlets E and F water sample test under the Action Level Exceedance, will submit by due date 01/27/2023.
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Based on water testing results, interviews, records review, facility tested over the Action Level Exceedance, in water outlet labled E and F. 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:Stephanie Hudak
LICENSING EVALUATOR NAME:Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2022


LIC809 (FAS) - (06/04)
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