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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005413
Report Date: 11/01/2022
Date Signed: 11/08/2022 08:41:07 AM

Document Has Been Signed on 11/08/2022 08:41 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:PENASQUITOS CHRISTIAN PRESCHOOLFACILITY NUMBER:
372005413
ADMINISTRATOR:VICTORIA MANNINGFACILITY TYPE:
850
ADDRESS:14484 PENASQUITOS DRIVETELEPHONE:
(858) 672-9353
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY: 115TOTAL ENROLLED CHILDREN: 115CENSUS: 49DATE:
11/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jennifer Kelly TIME COMPLETED:
09:40 AM
NARRATIVE
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This is an amended report
On 11/1/22 at 9:00 AM, LPA Annette Sutherland conducted an unannounced Case Management Inspection due to reported Lead Exceedance levels in the facility's water. LPA met with Jennifer Kelly. There were 49 children and 8 staff present in the preschool rooms. Water outlets reported 5.5 ppb or greater lead exceedance levels as follows:
Drinking Fountain (B) - Classroom (17.00 UG/L)
Sink Faucet (C) - Classroom (7.400 UG/L)
Sink Faucet (D) - Classroom (6.700 UG/L)
Drinking Faucet (H) - Outside (9.900 UG/L)
LPAs observed "Do not use" sign being posted by the drinking fountain in the Nursery Room (#4). Staff has already been made aware not to use. Ms. Kelly stated she is waiting for drinking faucet (B) to be removed and sink (C) to be replaced and will have it retested as soon as new fixture is put in. Sink faucet (D) located in the Koala room(#3) is not used for food preparation so it is still being used for hand washing. Drinking fountain (H) located in the playground area has also been removed. Sink faucet (C) in the nursery room is not being used as the classroom is currently closed and sink faucet is in the process of being replaced. Ms. Kelly stated that sink faucets (C) and (D) will be retested so that they are below the exceedance lead level.
See LIC 809D for Type A deficiency.
LPA Annette Sutherland informed facility representative Jennifer Kelly that this report dated 11/1/22 documents 1 Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA Annette Sutherland informed the facility representative Jennifer Kelly to provide a copy of this licensing report dated 11/1/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2022
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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Document Has Been Signed on 11/01/2022 12:02 PM - It Cannot Be Edited


Created By: Annette Sutherland On 10/31/2022 at 09:21 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: PENASQUITOS CHRISTIAN PRESCHOOL
FACILITY NUMBER: 372005413

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/31/2022
Section Cited

1017000.3(b)(1)

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101700.3(b)(1) Written Directives per AB2370: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:
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Ms. Kelly reported, drinking faucets are in exceedance are being removed (and posted a "Do not use" sign until) and sink faucets are being replaced, but are only being used for handwashing. MS. Kelly stated she will have the sink faucets tested as soon as they have been replaced. Ms. Kelly has submitted a Plan of correction detailing the faucet procedures.
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Based on water testing results and interviews, facility tested over the Lead Exceedance level at 4 sink faucet and drinking fountains measuring at 17.000 ppb , 7.400ppb, 6.700ppb, and 9.900. This poses an immediate/potential health, safety or personal rights risk to 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:Monica Cuddy
LICENSING EVALUATOR NAME:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2022


LIC809 (FAS) - (06/04)
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