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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430702587
Report Date: 10/07/2022
Date Signed: 10/07/2022 11:03:26 AM

Document Has Been Signed on 10/07/2022 11:03 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LEARNING CENTER, THEFACILITY NUMBER:
430702587
ADMINISTRATOR:EVANS-FITCH, PAULAFACILITY TYPE:
850
ADDRESS:459 KINGSLEY AVETELEPHONE:
(650) 325-6683
CITY:PALO ALTOSTATE: CAZIP CODE:
94301
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 27DATE:
10/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Paula Evans-FitchTIME COMPLETED:
11:15 AM
NARRATIVE
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On October 7, 2022 at 9:40am, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced to conduct a case management inspection due to the center's lead testing results. LPA met with director Paula Evans-Fitch. There were 27 children and an additional 6 staff members present.

It has been determined that there is one water faucet in the facility that has elevated lead levels established by a Certified External Water Sampler.

See LIC809D for deficiencies cited during today's inspection.

Exit interview conducted with director Paula Evans-Fitch. A notice of site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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 2
Document Has Been Signed on 10/07/2022 11:03 AM - It Cannot Be Edited


Created By: Julia Placencia On 10/07/2022 at 10:35 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
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARNING CENTER, THE
FACILITY NUMBER: 430702587

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/07/2022
Section Cited
CCR
101700.3(b)(1)

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101700.3(b)(1) Lead Testing Written Directive-
A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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POC: Director shall have a contractor repair the water outlet and submit a post-testing report to licensing by due date of 11/7/22. LPA observed the water has been turned off in this faucet to make it inoperable.
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This requirement is not met as evidenced by:
Based on record review, the licensee did not comply with the section cited above, which is a potential health and safety risk to persons in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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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:Jason Jang
LICENSING EVALUATOR NAME:Julia Placencia
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022


LIC809 (FAS) - (06/04)
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