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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364807987
Report Date: 04/07/2023
Date Signed: 04/07/2023 11:56:05 AM

Document Has Been Signed on 04/07/2023 11:56 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:SBCUSD-BRADLEY PRESCHOOLFACILITY NUMBER:
364807987
ADMINISTRATOR:AMY COKERFACILITY TYPE:
850
ADDRESS:1300 VALENCIA AVENUETELEPHONE:
(909) 388-6317
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 36TOTAL ENROLLED CHILDREN: 24CENSUS: 11DATE:
04/07/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Facility Representative Emily AguilarTIME COMPLETED:
12:10 PM
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On April 7, 2023, Licensing Program Analyst (LPA) Zirbes conducted an unannounced case management inspection. LPA Zirbes met with facility representative Emily Aguilar. The purpose of today's inspection was to conduct a case management inspection, and to notify the facility there has been a lead exceedance referred for an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.
Palmdale Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on the records reviewed outlet (B) an indoor sink faucet within the preschool classroom has an ALE of 7.9000 and outlet (E) a outdoor drinking fountain had an ALE of 5.7000. Information submitted to the Department reported the facility closed off outlets (E) on February 27, 2023. During this inspection, LPA observed a key locked cover placed on outdoor drinking fountain (E). The water to the outlet was still on, however the drinking fountain and water was inaccessible via the key locked cover placed over the drinking fountain. Potable water is available to preschool children via drinking fountains inside the classroom. In addition, some families provide their child with a water bottle each day.
Per written documentation received from San Bernardino School District, the facility plans to replace and retest outlets (B,E). Per conversation with facility representative, outlet (E) an outdoor drinking fountain has not been utilized for the past two years. Facility representative stated outlet E was accessible prior to February 27, 2023 however the children were directed to use the drinking fountains inside the classroom and discouraged from using the outdoor drinking fountains.
Per conversation with facility representative outlet (B) an indoor sink facet is only utilized by the staff for hand washing. Facility representative denied any fruit is washed utilizing the faucet and denied the children utilize outlet (B). Facility representative shared that all parents were notified of the lead exceedance via Classroom Dojo App. LPA observed the lead testing result and a notice was posted on the parent board in the classroom. LPA advised the facility to post a notice by the outlets indicating the outlets had a lead exceedance, since the water is still turned on.

Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SBCUSD-BRADLEY PRESCHOOL
FACILITY NUMBER: 364807987
VISIT DATE: 04/07/2023
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Report continued from page one

During the safety inspection, LPA observed the a section of the linoleum flooring measuring approximately 10inX10in was missing. LPA observed exposed wood and loose debris. This area of the floor is near the teachers desk and rolling chair and is not part of the children's play space, however is accessible to the children. Based on LPAS observation this may become a potential risk if the flooring continues to wear down. LPA advised the facility to monitor the space and ensure the area is clean and safe. LPA issued a advisory notice for regulation 101238.3 (b) Indoor Activity Space.

Based on the information received, outlet (E) a outdoor drinking fountain had an ALE of 5.7000 which is out of compliance with the allowable ALE of 5.5 ppb. Outlet (E) was utilized two years ago according to interviews conducted. Therefore a type B citation was issued Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, written directives, as this posed a potential risk to the children in care. Refer to LIC 809D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Emily Aguilar.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023
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Document Has Been Signed on 04/07/2023 11:56 AM - It Cannot Be Edited


Created By: Kendal Zirbes On 04/07/2023 at 10:56 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SBCUSD-BRADLEY PRESCHOOL
FACILITY NUMBER: 364807987

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/05/2023
Section Cited

101700.3

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101700.3 California Lead Action Level at Child Care Centers (a) California’s Action Level for lead in water at Child Care Centers is 5 ppb....result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance....Action Level Exceedance at any water outlet...is deemed not safe to drink ...immediate response ...shall be required
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Per written documentation from the school district, Outlet (E) was closed off on February 27, 2023. Potable water is available to the children via alternative drinking fountains. The school district plans to replace and retest outlet (E). Documentation of the replacement and retesting will be submitted to the Department.
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This requirement was not met as evidenced by: Based on the information received, outlet (E) had an ALE of 5.7000, which is out of compliance with the allowable ALE of 5.5 ppb. Outlet (E) was utilized two years ago. This poses a potential health and safety risk for 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:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2023


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