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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414003043
Report Date: 11/17/2023
Date Signed: 11/17/2023 04:25:02 PM

Document Has Been Signed on 11/17/2023 04:25 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:P.A.R.C.A. PROJECT REACHFACILITY NUMBER:
414003043
ADMINISTRATOR:HINKSTON, CECILIAFACILITY TYPE:
840
ADDRESS:130 CAMBRIDGE LANETELEPHONE:
(650) 871-8402
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 18DATE:
11/17/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
04:07 PM
MET WITH:Cecilia HinkstonTIME COMPLETED:
04:40 PM
NARRATIVE
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On November 17, 2023, Licensing Program Analyst (LPA)Tso met with director, Cecilia Hinkston. The purpose of inspection was explained and was for an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA was given a tour of the facility. Present in the facility was the director and 6 staff supervising 18 children. The facility is in compliance with staff-child ratios.

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 December 22, 2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The affected fixture is, fixture A (6.6). The facility was proactive in getting that drinking fountain (fixture A) removal. The affected fixture A was removed on February 11, 2023. Per Written Directives 101700.3(b)(2), licensees shall maintain a lead value at or below 5ppb in all outlets subject to testing requirements for the health and safety of children in care. The Written Directives are included in HSC 1597.16 and are specific guidelines for facilities to adhere to regarding lead water testing. Due to updated guidance on the written directives in the PIN 21-21.1-CCP, the facility will be cited for the action level exceedance of the fixture. The deficiency will be cleared at the same day of the visit because the affected fixtures have been removed. The ALE issue had been cleared since February 11, 2023.

* See next page for deficiencies cited today

This report was reviewed and signed by Director, Cecilia Hinkston.

This notice of Site visit was provided to the licensee and must remain posted for 30 days.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2023
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 11/17/2023 04:25 PM - It Cannot Be Edited


Created By: Man Tso On 11/17/2023 at 04:14 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: P.A.R.C.A. PROJECT REACH
FACILITY NUMBER: 414003043

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2023
Section Cited
HSC
1597.16

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WD101700.3(b)(2) Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.

This requirement was not met as evidenced by:
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The facility took steps to remediate to remove the affected fixture on 2/11/23. The facility is now in compliance.

This deficiency was cited and cleared at the same day of the visit, 11/17/2023.
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Based upon record review, the facility had a fixture (A) that tested above the Action Level of 5ppb. This posed a potential health, safety, or personal rights risk to persons 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:Ali Zebila
LICENSING EVALUATOR NAME:Man Tso
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2023


LIC809 (FAS) - (06/04)
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