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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621604
Report Date: 01/03/2023
Date Signed: 01/03/2023 04:53:17 PM

Document Has Been Signed on 01/03/2023 04:53 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MARCI MASSEI CHILD DEVELOPMENT CENTERFACILITY NUMBER:
393621604
ADMINISTRATOR:LILLIAN URREAFACILITY TYPE:
830
ADDRESS:215 WEST FIFTH STREETTELEPHONE:
(209) 207-5611
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 1DATE:
01/03/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Assistant Director, Gloria BarberoTIME COMPLETED:
05:25 PM
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Licensing Program Analyst (LPAs) Lauren Scott and Carla Polanco Rivera met with Assistant Director, Gloria Barbero for a Case Management inspection. The purpose of the inspection was to follow-up on a lead testing report dated 10/28/2022 which tested the water in the facility.

The report revealed that one water outlet had elevated levels of lead. Director reported that the fountains had been marked as "NOT IN USE" and were currently inaccessible for use. Director also stated once the report was received, the facility closed the outlet and purchased a portable sink to take the place of the sink with the exceedance. LPA observed new sink in place at time of visit. Assistant Director stated the water for the portable sink comes from the outlet in the bathroom and is only used for hand washing.

As a result of the water testing positive for lead, a deficiency was cited on a subsequent page, LIC809D. An exit interview was conducted and the report was reviewed with Assistant Director.



A Notice of Site was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2023
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 2
Document Has Been Signed on 01/03/2023 04:53 PM - It Cannot Be Edited


Created By: Lauren Scott On 01/03/2023 at 04:19 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MARCI MASSEI CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 393621604

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/03/2023
Section Cited

101700.3(b)(1)

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Lead Testing (b)(1) A result which values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by:
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During today's visit LPA observed that the affected water outlets are not in use. Sink is closed and marked "NOT IN USE." Facility put a portable sink in front of the sink with the exceedance. Deficiency will be cleared during visit.
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The water report dated 10/28/2022 revealed that the facility had elevated levels of lead in one water fountain. This is a potential health and safety 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:Chayntel Hunter
LICENSING EVALUATOR NAME:Lauren Scott
LICENSING EVALUATOR SIGNATURE:
DATE: 01/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/03/2023


LIC809 (FAS) - (06/04)
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