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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600342
Report Date: 12/05/2022
Date Signed: 12/05/2022 09:42:34 AM

Document Has Been Signed on 12/05/2022 09:42 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:KINDERCARE PASEO MONTRIL PRESCHOOLFACILITY NUMBER:
376600342
ADMINISTRATOR:ALMA GANDARILLAFACILITY TYPE:
850
ADDRESS:10065 PASEO MONTRILTELEPHONE:
(858) 484-3232
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 27DATE:
12/05/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:TIME COMPLETED:
10:00 AM
NARRATIVE
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On 12/5/22 at 9:30 AM , LPA Annette Sutherland conducted an unannounced Case Management Inspection due to reported Lead Exceedance levels in the facility's water. LPA met with Assistant director, Houda Ahmadi. There were 27 children and 3 staff present in the preschool rooms. 

Water outlets reported with 5.5 ppb or greater lead exceedance levels as follows:

Sink Faucet/Drinking Faucet - Classroom  (8.120 UG/L)

LPAs observed  "Do not use" signs being posted by the sink faucet during visit.  Assistant director stated she is still waiting for the retest results and will no longer use the sink/drinking faucet until the results show the sink faucet/drinking faucet is below the exceedance lead level.

See LIC 809D for Type A deficiency.

LPA Annette Sutherland informed facility representative Alma Ahmadi that this report dated 12/5/22 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 Houda Ahmadi to provide a copy of this licensing report dated 12/5/22 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: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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 12/05/2022 09:42 AM - It Cannot Be Edited


Created By: Annette Sutherland On 11/28/2022 at 05:47 PM
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: KINDERCARE PASEO MONTRIL PRESCHOOL
FACILITY NUMBER: 376600342

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/29/2022
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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Director reported, sink faucet/drinking faucet are in exceedance were replaced, and posted a "Do not use" sign until the results in the retest are lower than the exeedance level.
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Based on water testing results and interviews, facility tested over the Lead Exceedance level at 1 sink faucet measuring one at 110 ppb. 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: 11/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2022


LIC809 (FAS) - (06/04)
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