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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600490
Report Date: 12/07/2022
Date Signed: 12/07/2022 10:21:06 AM

Document Has Been Signed on 12/07/2022 10:21 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:EASTLAKE COMMUNITY CHURCH PRESCHOOLFACILITY NUMBER:
376600490
ADMINISTRATOR:SHERRIANN KELLYFACILITY TYPE:
850
ADDRESS:2351 OTAY LAKES ROADTELEPHONE:
(619) 421-4156
CITY:CHULA VISTASTATE: CAZIP CODE:
91915
CAPACITY: 174TOTAL ENROLLED CHILDREN: 174CENSUS: 118DATE:
12/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sherri KellyTIME COMPLETED:
10:29 AM
NARRATIVE
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On 12/07/2022 at approximately 09:00 AM, Licensing Program Analyst (LPA) Edgar Campana conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of lead detected in facility water fixtures. LPA met with facility director, Sherri Kelly. The purpose of the inspection was explained, and facility was toured. Present in facility were 118 children with 24 staff.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

LPA obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), on 11/09/2022.

On 10/27/2022 the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 10/20/2022. The outlets/fixtures reported with 5.5 ppb or greater lead exceedance levels were as follows:

M – Sink Faucet located in the boy's restroom on the 1st floor, across from kitchen
R – Sink Faucet located in the boy's restroom on the 1st floor, near main entry
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: EASTLAKE COMMUNITY CHURCH PRESCHOOL
FACILITY NUMBER: 376600490
VISIT DATE: 12/07/2022
NARRATIVE
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Facility director, Sherri Kelly, stated that both fixtures were replaced on 11/01/2022 and were retested on 12/01/2022. Director further stated that fixtures will remain inaccessible until test results show that lead levels are below exceedance levels. LPA confirmed that fixtures are covered and out of service.

Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

LPA informed facility director that this report dated 12/07/2022 documents one (1) Type B citation on the attached 809-D.

LPA advised director that parents must be notified of the lead exceedances. Licensees shall post testing results, in a location consistent with the requirements of subsection (b) of section 1596.8595 of the Health & Safety Code, for parents and families to view at the facility within 24 hours of receiving the results from the Department.

Exit interview conducted and report was reviewed with Director, Sherri Kelly. A copy of this report, along with Appeal Rights (LIC9058 03/22), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022
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Document Has Been Signed on 12/07/2022 10:21 AM - It Cannot Be Edited


Created By: Edgar Campana On 12/06/2022 at 08:05 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: EASTLAKE COMMUNITY CHURCH PRESCHOOL
FACILITY NUMBER: 376600490

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/07/2023
Section Cited

101700.3(b)(1)

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101700.3 California Lead Action Level at Child Care Centers. (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) 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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The facility has made outlets that tested with an ALE out of service and posted appropriate signage. Director stated they have replaced the impacted outlets. Fixtures were retested by a certified water sampler on 12/01/22, following the protocol outlined in Written Directives, Section 101705. Director stated that parents will be notified of the lead exceedances.

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Based on record review, the facility was found out of compliance with the above directive, as two (2) outlets not used for drinking and/or food preparation tested with an Action Level Exceedance (ALE). This poses a potential Health and Safety risk to children in care.
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Director stated the POC will be provided to the San Diego Regional Office no later than 01/07/2023. (within 30 days)

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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:Jason Garay
LICENSING EVALUATOR NAME:Edgar Campana
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022


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