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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600786
Report Date: 03/28/2023
Date Signed: 03/28/2023 12:27:37 PM

Document Has Been Signed on 03/28/2023 12:27 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:NCCS CHILD DEVELOPMENT CENTER-EUCALYPTUSFACILITY NUMBER:
376600786
ADMINISTRATOR:SANDRA ROMEROFACILITY TYPE:
850
ADDRESS:1805 S. ESCONDIDO BLVD.TELEPHONE:
(760) 745-1302
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 22DATE:
03/28/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Shonna Brookin-WigginsTIME COMPLETED:
12:40 PM
NARRATIVE
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On 03/28/23, Licensing Program Analysts (LPA) Sumayya Habeebulla, conducted a Case Management visit in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPA met with Director, Shonna Brookins-Wiggins who was informed of the reason for the visit.

Assembly Bill 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers constructed before January 1, 2010, to test their drinking and cooking water for lead contamination between January 1, 2020, and January 1, 2023, and then every 5 years after the date of the first lead testing. LPA observed on the report provided by the SWRCB the FAUCET E (Drinking Water Fountain) identified as having high levels of lead.

The Sink faucet A is located in the Preschool Kitchen. The Director stated the faucet has been replaced but not retested yet. Facility was unaware that they were not supposed to be using the faucet until retesting has been completed. Facility has ceased usage of the faucet located in the Kitchen as of this date and will resume once the testing has been completed and reading is below the Action level exceedance. The Director stated she will be scheduling the retest for the specified faucet soon and will keep the Department updated about the results.

Interviews with staff revealed that the Sink faucet A has been replaced but was in use.

See LIC 809D for cited deficiency in accordance with the California Code of Regulations Title 22, Division 12 written directives.

An exit interview was conducted with the Director Shonna BrookinsWiggins. A copy of this report, appeal rights and a Notice of Site Visit was issued.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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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Document Has Been Signed on 03/28/2023 12:27 PM - It Cannot Be Edited


Created By: Sumayya Habeebulla On 03/28/2023 at 12:12 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: NCCS CHILD DEVELOPMENT CENTER-EUCALYPTUS
FACILITY NUMBER: 376600786

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/27/2023
Section Cited

101700.3(b)(1)

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California Lead Action Level at Child Care Centers(b) Testing results...ppb readings of 0.5 ppb or greater...(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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The facility has replaced the Sink Faucet in the Kitchen and will not be using it until it is retested and no longer has an exceedance.
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This requirement was not met as evidenced by:
LPA received the facility's water testing results for Sink Faucet A with an Action Level Exceedance higher than the allowable limit.
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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:Carlos Martinez
LICENSING EVALUATOR NAME:Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2023


LIC809 (FAS) - (06/04)
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