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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600708
Report Date: 06/01/2023
Date Signed: 06/01/2023 12:42:50 PM

Document Has Been Signed on 06/01/2023 12:42 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:NHA EARLY LINK-SKILL CENTERS OF AMERICA HEAD STARTFACILITY NUMBER:
376600708
ADMINISTRATOR:MERRYANN JENKINSFACILITY TYPE:
850
ADDRESS:6285 UNIVERSITY AVENUETELEPHONE:
(619) 243-1607
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 88TOTAL ENROLLED CHILDREN: 88CENSUS: 47DATE:
06/01/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Merryann JenkinsTIME COMPLETED:
01:00 PM
NARRATIVE
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On 06/01/23 at 11:25am, Licensing Program Analyst (LPA), Samantha Clenista conducted an unannounced case management inspection for the Action Level Exceedance (ALE) of lead detected in facility water fixture. Upon arrival, LPA conducted a tour of the facility and counted a total of 47 children with a total of 9 staff members. Appropriate capacity, ratio and supervision was observed. All staff members have the required background clearances and are associated to the facility. Director arrived to the facility during the inspection.

LPA Clenista 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 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 Nancy Diaz obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276) Facility Sketch (LIC999) from Director via email on 03/13/2023, and a physical copy was obtained during today's inspection. Facility posted the lead exceedance result the day it was received at the facility's entrance door.

On 05/02/23, 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 09/10/22. The outlets/fixtures reported with 5.5 ppb or greater lead exceedance levels was as follow:
  • Outlet B- Kitchen water dispenser which tested at 19.85 ppb
  • Outlet B30- Dispense (colder water flushed) located in the kitchen which tested at 11.49 ppb
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2023
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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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: NHA EARLY LINK-SKILL CENTERS OF AMERICA HEAD START
FACILITY NUMBER: 376600708
VISIT DATE: 06/01/2023
NARRATIVE
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Director stated that the faucet that had the lead exceedance was immediately wrapped up and inoperable upon receiving the lead results. Facility has completely removed the faucet. Facility has a refillable water jug station located in each classroom and cups available for staff and children. Facility orders 5 gallon water jug from Arrowhead to refill their water bottles and/or cups.

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.

See LIC809D for type B citation issue. Exit interview conducted and report was reviewed with Director. 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: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/01/2023 12:42 PM - It Cannot Be Edited


Created By: Samantha Clenista On 06/01/2023 at 11:59 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: NHA EARLY LINK-SKILL CENTERS OF AMERICA HEAD START
FACILITY NUMBER: 376600708

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/01/2023
Section Cited
CCR
101700.3

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Facility failed to maintain a lead value at or below the Action Level for water lead testing resulting with values of 5.5 ppb or greater for two water faucets located in the facility’s kitchen. Water testing results identified with Action Level Exceedance as defined in WD/Written Directive section 101700.3 are deemed not safe to use for drinking or any food preparation.
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Director stated that the faucet that had the lead exceedance was immediately wrapped up and inoperable once the facility received the lead results. Facility has completely removed the faucet. Facility has a refillable water jug station located in each
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This requirement is not met as evidence by: Based on record review, the licensee did not comply with the directive above, as two water faucets located in the facility’s kitchen tested with an Action Level Exceedance (ALE). This poses a potential health and Safety risk to children in care.
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classroom and cups available for staff and children. Facility orders 5 gallon water jug from Arrowhead to refill their water bottles and/or cups. Deficiency is cleared. POC letter was provided to Director at conclusion of visit.

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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:Samantha Clenista
LICENSING EVALUATOR SIGNATURE:
DATE: 06/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/01/2023


LIC809 (FAS) - (06/04)
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