<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380500487
Report Date: 09/30/2022
Date Signed: 09/30/2022 10:18:18 AM

Document Has Been Signed on 09/30/2022 10:18 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ONE FIFTY PARKER AVENUE NURSERY SCHOOLFACILITY NUMBER:
380500487
ADMINISTRATOR:JARROD RONDEAUFACILITY TYPE:
850
ADDRESS:150 PARKER AVETELEPHONE:
(415) 221-0294
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 27DATE:
09/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:34 AM
MET WITH:Steven KongTIME COMPLETED:
10:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On September 30, 2022 at approximately 09:00am, Licensing Program Analyst (LPA) Nathan Garcia conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with the Site Director, Steven Kong. The purpose of the inspection was explained.

Present in facility are 27 children, present with 7 staff members during outdoor play.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers 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.

The facility received the ALE report from the Vendor on 8/16/2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and putting signs indicating that the water fountain/kitchen fixture is not for drinking and or currently out of order. Per director, there are no intentions of using the faucets affected with high level of lead for water ingestion or food preparation. The faucet located in the classroom bathroom has been shut off entirely and will not be in use. The other fixtures located in the classrooms will only be used to washing supplies. Per director, the facility provides the children with cups and have been using water services. The bottles are replenished by using the filtered water or store bought bottled water, as needed. The facility director also notified the parents regarding their water lead exceedance in a letter. A copy of this letter will be provided to the LPA.

LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), in an email to the LPA.

A copy of this report, and the “Notice of Site Visit,” were given to the director.

A “Notice of Site Visit” must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Director, Steven Kong.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1