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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340321306
Report Date: 02/07/2024
Date Signed: 02/07/2024 03:55:24 PM

Document Has Been Signed on 02/07/2024 03:55 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CHOICES CHARTERFACILITY NUMBER:
340321306
ADMINISTRATOR:CERNAT, TATIANAFACILITY TYPE:
850
ADDRESS:4425 LAURELWOOD WAYTELEPHONE:
(916) 575-2368
CITY:SACRAMENTOSTATE: CAZIP CODE:
95864
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 21DATE:
02/07/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maureen Baer-YoungTIME COMPLETED:
11:30 AM
NARRATIVE
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On Wednesday February 7th 2024, Licensing Program Analyst (LPA) Mandie Goodwin met with lead teacher Maureen Baer-Young to conduct an unannounced case management inspection. During today's inspection there were 21 preschool children being supervised by 3 teachers in room 20. The purpose of today's inspection was to create a plan of correction following a report of lead exceedance in one of the facility outlets.

On 12/7/23, the facility tested water samples for lead. One water outlet sampled indicated an Action Level Exceedance (ALE). This outlet is marked D on the facility sketch provided by the center. This outlet correlates to a drinking fountain located inside classroom 19. Outlet tests at 5.6ppb. The facility was notified that water lead levels were in exceedance of 5.5 parts per billion in outlet D, and that corrective actions are being taken.

Facility representatives informed LPA that outlet D has not been used by children since the outlet is located in a classroom that is not currently used by children. LPA observed that the classroom is empty and that the faucet has been made inaccessible by being covered and a notice not to use until corrections are made. A plan of correction is being issued to ensure that outlet D is made inoperable, removed, and/or replaced. All other faucets used by preschool children have been tested and are not in Action Level Exceedance.

A deficiency is cited on the following LIC809-D and the plan of correction was reviewed with the Lead teacher Maureen Baer-Young A copy of this report and appeal rights were provided, as well as a notice of site visit which much remain posted for 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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Document Has Been Signed on 02/07/2024 03:55 PM - It Cannot Be Edited


Created By: Mandie Goodwin On 02/07/2024 at 11:02 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: CHOICES CHARTER
FACILITY NUMBER: 340321306

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/21/2024
Section Cited
HSC
101700.3(b)(1)

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101700.3 ...Lead Action Level... (b) ...(1) If testing indicates an Action Level Exceedance at any water outlet, the water... is deemed not safe to drink and an immediate response... shall be required. This requirement was not met as evidenced by:
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Facility provided proof that the outlet has been made inaccessable and that alternate water source is available. Facility will continue to make corrections to bring lead results to under 5.5ppb or permenantly remove drinking fountain.
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Based on record review the facility did not comply with the above regulation as the lead action level was exceeded in one water outlet, which poses Health, Safety, or Personal Rights risk to persons 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:Seychelle De Luca
LICENSING EVALUATOR NAME:Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


LIC809 (FAS) - (06/04)
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