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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406696
Report Date: 01/26/2023
Date Signed: 01/26/2023 12:07:28 PM

Document Has Been Signed on 01/26/2023 12:07 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOLFACILITY NUMBER:
444406696
ADMINISTRATOR:REGINA SANCHEZFACILITY TYPE:
850
ADDRESS:40 BLANCA LANETELEPHONE:
(831) 724-0175
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 70TOTAL ENROLLED CHILDREN: 63CENSUS: 41DATE:
01/26/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Regina SanchezTIME COMPLETED:
12:16 PM
NARRATIVE
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Director, Regina Sanchez, and explained purpose of visit- to follow-up on water lead testing conducted for the facility. Upon arrival, LPA toured the facility and requested Site Director identify faucet with Action Level Exceedance (value of 5.5 parts per billion or greater).

LPA received the following documents via email from Regina on 1/13/2023: Self-Certification (LIC9275) completed by Certified External Water Sampler, Sampling Checklist Form (LIC9276), and Facility Sketch (LIC999) labeled with locations of water outlets. Paper copies of the documents were additionally mailed to the San Jose Regional Office.

Water sample was conducted by ERC Diligence on 11/29/2022 and the report indicated that faucet "E" had Action Level Exceedance value of 9.3. The faucet is located outside of the facility, in a grass area with limited use by children. The facility has remediated faucet "E" by fully replacing the drinking fountain unit and it is currently made inaccessible to children until water lead testing is redone. LPA observed that the drinking fountain is covered with a bag so it will not be used by children. Regina states that faucet will be retested and she will submit retesting results to Licensing upon completion. The date for retesting is currently unknown, however Regina states that she has let upper management know about the required lead retesting. LPA requested that Regina let Licensing know when she has a confirmed date for the faucet retesting.

Exit interview conducted and report was reviewed with the Site Director, Regina Sanchez.

As a result of todays inspection, a deficiency was cited, see 809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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 01/26/2023 12:07 PM - It Cannot Be Edited


Created By: Cortney Nelson On 01/26/2023 at 11:48 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOL
FACILITY NUMBER: 444406696

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
02/28/2023
Section Cited

101700.3(b)(1)

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Lead Testing Written Directives (b)(1) a result with values of 5.5 parts per billion or greater shall be deemed an Action Level Exceedance (ALE).

This requirement was not met as evidenced by:
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The facility has completely replaced the drinking fountain (faucet E) and is planning to get it rested to confirm that replacing the fountain has resolved the water lead ALE result.
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After water lead testing was completed, the facility had one faucet (E) located in the outdoor preschool play area with an Action Level Exceedance of 9.3, which poses a potential risk to the health, safety, and personal rights of children in care.
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The facility will notify Licensing when the restesting has been scheduled for faucet E and will submit water lead testing results when completed. The faucet will remain inaccessible to children until retesting completed.

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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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023


LIC809 (FAS) - (06/04)
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