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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340317946
Report Date: 01/07/2025
Date Signed: 01/07/2025 11:36:54 AM

Document Has Been Signed on 01/07/2025 11:36 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:EARL WARREN PRESCHOOLFACILITY NUMBER:
340317946
ADMINISTRATOR/
DIRECTOR:		SARABA, SUZANNEFACILITY TYPE:
850
ADDRESS:5420 LOWELL STREETTELEPHONE:
(916) 382-5934
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 19DATE:
01/07/2025
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Suzanne SarabaTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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 Tuesday, January 7 2025, Licensing Program Analysts (LPAs) Tanya Washington and Julia Maryanova met with Site Supervisor, Suzanne Saraba to conduct an unannounced case management inspection for a reported Lead Exceedance in an outdoor drinking fountain. The purpose of today's inspection is to follow on the correction of violation issued on 10/08/2024.

It was reported that on 12/26/2022, the outdoor drinking faucet tested for lead exceedance. One water outlet sample indicated an Action Level Exceedance (ALE). The outlet that tested in exceedance is drinking fountain B located outside with 36 ppb.

Per Site Supervisor all oudoor drinking fountains have been replaced, however there is no verification that the lead exceedance is within normal range. The facility was notified that water lead levels were in exceedance of 5.5 parts per billion.

A deficiency is cited on the following LIC809-D page and the plan of correction was reviewed with the Site Supervisor.



A copy of this report and appeal rights were provided. A notice of site visit was provided and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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 01/07/2025 11:36 AM - It Cannot Be Edited


Created By: Tanya Washington On 01/07/2025 at 11:20 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: EARL WARREN PRESCHOOL
FACILITY NUMBER: 340317946

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/07/2025
Section Cited

1017003(b)(1)

1
2
3
4
5
6
7
California Lead Action Level at Child Care Centers (b) Testing results with ... (1) A .. values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement has not been met by evidence: Outlet B (drinking fountain outside) has a lead exceedance of 36 ppb. This is considered as a potential
1
2
3
4
5
6
7
Per Site Supervisor the fountains have been replaced, however there is no verification of normal range levels.

Proof of correction can be sent to LPA via email - tanya.washington@dss.gov
8
9
10
11
12
13
14
risk to the health and safety of children in care.
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:Amanda Blesi
LICENSING EVALUATOR NAME:Tanya Washington
LICENSING EVALUATOR SIGNATURE:
DATE: 01/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/07/2025


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