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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340318058
Report Date: 03/05/2024
Date Signed: 03/05/2024 10:09:25 AM

Document Has Been Signed on 03/05/2024 10:09 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:SUNRISE STATE PRESCHOOLFACILITY NUMBER:
340318058
ADMINISTRATOR:MACIAS, CHRISTINAFACILITY TYPE:
850
ADDRESS:7322 SUNRISE BLVD.TELEPHONE:
(916) 971-5220
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 77TOTAL ENROLLED CHILDREN: 77CENSUS: 51DATE:
03/05/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Bertha HernandezTIME COMPLETED:
10:20 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
Licensing Program Analysts (LPAs) Stephanie Piring and Soleil Marx met with Facility Representative, Bertha Hernandez to conduct an unannounced case management inspection regarding lead testing. The purpose of today's inspection was to document a plan of correction following reports of lead exceedance in one of the facility outlets.

On 12/21/2023, the facility tested water samples for lead. Lead testing identified one water outlet that has a Lead Exceedance over the amount of 5.5 parts per billion (ppb). The water outlet designated as outlet F has an exceedance of 12 ppb.



Facility Representative stated water outlet with lead exceedance were covered and placed out of order, the fixtures have been replaced and awaiting retesting. The facility is using an alternative water source, filtered water in pitchers.


A deficiency is cited on the subsequent page of the report and is considered a potential threat to the health and safety of children in care. An exit interview was conducted with the Facility Representative. LPA provided Facility Representative with Appeal Rights and a Notice of Site Visit that must be posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Stephanie Piring
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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 03/05/2024 10:09 AM - It Cannot Be Edited


Created By: Stephanie Piring On 03/05/2024 at 09:47 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: SUNRISE STATE PRESCHOOL
FACILITY NUMBER: 340318058

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/05/2024
Section Cited

101700.3(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 is not met as evidenced by:
1
2
3
4
5
6
7
Usage of the faucet was stopped immediately upon receiving the results. Facility Representative stated the faucet has been changed and awaiting retesting. Alternative filtered water dispenser is being used.
8
9
10
11
12
13
14
Based on record review, one water outlet tested exceeded the allowed 5.5 ppb, which poses/posed a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Facility plan retest, the faucet. Facility Representative will send updated passing results to LPA Piring prior to using the fixtures.

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:Natalie Dunaway
LICENSING EVALUATOR NAME:Stephanie Piring
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024


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