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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700353
Report Date: 12/14/2023
Date Signed: 12/14/2023 11:16:16 AM

Document Has Been Signed on 12/14/2023 11:16 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:KIDDIE ACADEMY CHILDCARE LEARNING CENTERFACILITY NUMBER:
376700353
ADMINISTRATOR:PLANT, LISAFACILITY TYPE:
850
ADDRESS:3766 MISSION AVENUE #110TELEPHONE:
(760) 439-5552
CITY:OCEANSIDESTATE: CAZIP CODE:
92058
CAPACITY: 126TOTAL ENROLLED CHILDREN: 126CENSUS: 59DATE:
12/14/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Evelyn AvilaTIME COMPLETED:
11:25 AM
NARRATIVE
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On December 14,2023 at 9:20AM, Licensing Program Analysts (LPAs) Amber Shaw and Cindy Hamilton made an unannounced Case Management inspection, for the reported Lead Exceedance in the facility’s water. LPAs met with Director Evelyn Avila and proceeded to tour the facility.

LPAs interviewed the director and examined the water faucets deemed to have an Action Level Exceedance. The required signed and dated forms (LIC 9275/9276), and facility sketch with labeled water outlets were submitted to Community Care Licensing via email on 10/17/23.

Faucets reported with 5.5 ppb (parts per billion) or greater lead exceedance levels were as follows:


Faucet/sink labeled E located in the kitchen area 06.8 ppb

Faucet/sink labeled Q located in women’s restroom 15.00 ppb

Faucet/sink labeled R located in men’s restroom 7.3. ppb


At the time of the inspection LPA’s observed the water faucet “E” “Q” and “R” were not bagged or covered otherwise, to prevent the faucet from being used by children or staff. Per the director all of the faucets have been replaced on 11/09/23, and another water sample will be scheduled for lead testing. LPA’s advised director to make faucet labeled “E”, “Q” and “R” inaccessible, and director placed a do not use sign and covered the faucets with a plastic bag at the time of the inspection.

Per director, the water faucets in the kitchen and restrooms are not used for drinking or food preparation, only handwashing. The children in care are provided filtered drinking water. Director stated some children bring their own water containers and staff will use the faucet located in each classroom to refill the containers with water if needed.

Per director parents were NOT notified of the lead exceedance in the water, at time of the inspection LPA’s advised director to post the lead results in the parent communication board.

Based on records review and information received, and current policies and procedures for the Department, the facility is being cited for having a lead exceedance in faucet labeled letter E located in kitchen, faucet/sink labeled letter Q in women’s restroom and faucet/sink labeled letter R located in men’s restroom, under the Written Directives, Section 101700.3 (b) (1) California Lead Action Level at Child Care Centers.

See LIC809-D cited deficiency. Technical Assistance was provided to the director in regard to Physical Plant/Buildings and Grounds.

LPA Shaw informed Director Evelyn Avila that this report dated 12/14/2023 documents one Type A citation. A Type A citation(s) shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPAs informed Director to provide a copy of this licensing report dated 12/14/23 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.

Exit interview conducted and report was reviewed with Director Evelyn Avila. A notice of site visit was given and must remain posted for 30 days. LPA observed Director post notice of site visit.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Amber Shaw
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2023
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KIDDIE ACADEMY CHILDCARE LEARNING CENTER
FACILITY NUMBER: 376700353
VISIT DATE: 12/14/2023
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Per director, the water faucets in the kitchen and restrooms are not used for drinking or food preparation, only handwashing. The children in care are provided filtered drinking water. Director stated some children bring their own water containers and staff will use the faucet located in each classroom to refill the containers with water if needed.

Per director parents were NOT notified of the lead exceedance in the water, at time of the inspection LPA’s advised director to post the lead results in the parent communication board.

Based on records review and information received, and current policies and procedures for the Department, the facility is being cited for having a lead exceedance in faucet labeled letter E located in kitchen, faucet/sink labeled letter Q in women’s restroom and faucet/sink labeled letter R located in men’s restroom, under the Written Directives, Section 101700.3 (b) (1) California Lead Action Level at Child Care Centers.

See LIC809-D cited deficiency. Technical Assistance was provided to the director in regard to Physical Plant/Buildings and Grounds.

LPA Shaw informed Director Evelyn Avila that this report dated 12/14/2023 documents one Type A citation. A Type A citation(s) shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPAs informed Director to provide a copy of this licensing report dated 12/14/23 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.

Exit interview conducted and report was reviewed with Director Evelyn Avila. A notice of site visit was given and must remain posted for 30 days. LPA observed Director post notice of site visit.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Amber Shaw
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/14/2023 11:16 AM - It Cannot Be Edited


Created By: Amber Shaw On 12/14/2023 at 11:04 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KIDDIE ACADEMY CHILDCARE LEARNING CENTER
FACILITY NUMBER: 376700353

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/14/2023
Section Cited

101700.3(b)(1)

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101700.3 (b) (1) Written Directives...A result
with values of 5.5 ppb or greater shall be
deemed an Action Level Exceedance.
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Director made faucets/sinks E, Q, and R inaccesible for use at the time of inspection. Director agrees to submit results of the water sample test for faucets labeled E, Q, and R until level of lead is below action level exceedance. Director will also submit documentation on or before POC due date
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Based on water testing results, facility tested over the Action Level Exceedance, in water facuets/sinks labeled E, Q, and R. This poses an immediatte health, safety, or personal rights risk to the 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:Carlos Martinez
LICENSING EVALUATOR NAME:Amber Shaw
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2023


LIC809 (FAS) - (06/04)
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