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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701465
Report Date: 12/01/2022
Date Signed: 12/01/2022 03:25:37 PM

Document Has Been Signed on 12/01/2022 03:25 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:EES PARKS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376701465
ADMINISTRATOR:FRANCES TUMANGDAYFACILITY TYPE:
850
ADDRESS:2200 E AVENUE #5777TELEPHONE:
(619) 477-9602
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 72TOTAL ENROLLED CHILDREN: 24CENSUS: 13DATE:
12/01/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Frances TumangdayTIME COMPLETED:
03:30 PM
NARRATIVE
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On 12/01/2022 at 2:00 PM, Licensing Program Analyst, Dana Stevens made an unannounced CASE MANAGEMENT inspection, for reported Lead Exceedance. LPA met with Site Director Frances Tumangday. Facility was within ratio & capacity. LPA interviewed director and examined the water source (spigot) deemed at Action Level Exceedance.

Spigot reported with 5.5 ppb or greater lead exceedance levels are as follows:

Kitchen Sink faucet Spigot A (not for children use) 5.88 ppb


Site Director stated that spigot has already been replaced and is being flushed 4 times daily for 30 seconds as directed and spigot will be retested in 3 to 4 weeks time. Spigot remains covered and labeled not for use. SIte Director states the kitchen spigot was used for washing dishes, so Center is temporarily using paper plates and plastic utensils. Center provides bottled drinking water for all children and staff. All spigots inside the classrooms are not in exceedance. All staff have been informed not to use spigot in exceedance for any reason.

See LIC809D for Type B deficiency cited.

Exit interview conducted. Appeal rights were discussed and given to director on this date. Notice of Site Visit was given to director and must be posted for 30 days.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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 12/01/2022 03:25 PM - It Cannot Be Edited


Created By: Dana Stevens On 12/01/2022 at 02:59 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: EES PARKS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 376701465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/09/2023
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.
This requirement is not met as evidenced by:

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Spigot has been replaced and is not in use. Spigot is routinely flushed as required. A second testing will be completed in three to four weeks and Director will provide LPA with the results.
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Based on water testing results and interview, facility tested over the Action Level Exceedance level at one water outlet (spigot). This may pose a 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:Cynthia Gray
LICENSING EVALUATOR NAME:Dana Stevens
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022


LIC809 (FAS) - (06/04)
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