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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009876
Report Date: 08/24/2022
Date Signed: 08/24/2022 03:29:57 PM

Document Has Been Signed on 08/24/2022 03:29 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LITTLE WILDFLOWERS PRESCHOOL, INC.FACILITY NUMBER:
493009876
ADMINISTRATOR:EVELYN CONTRERASFACILITY TYPE:
850
ADDRESS:1275 & 1281 EDWARDS AVENUETELEPHONE:
(707) 308-4282
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 55TOTAL ENROLLED CHILDREN: 22CENSUS: 19DATE:
08/24/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Evelyn ContrerasTIME COMPLETED:
03:45 PM
NARRATIVE
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On 08/24/22 at 2:00pm, Licensing Program Analyst (LPA), Amy Strother made a case management inspection and met with Licensee Evelyn Contreras (L1). The inspection was made in response to water lead testing results received from the California State Water Resource Control Board. The test results showed that the following faucets tested above the allowable level of 5 parts per billion (ppb) of lead in the water: Outdoor Drinking Fountain "D" tested at 30 ppb.

L1 has made the drinking fountain inaccessible by shutting the water off on the faucet. L1 stated the drinking fountain has never been used by children in her care as the facility was licensed on 03/17/20 when the State of Emergency COVID-19 pandemic began, and L1 didn't want children sharing a drinking fountain. L1 stated that children receive drinking water from individual reusable water bottles used while indoors and outdoors. L1 further stated that the children's water bottles are filled using a Brita water pitcher that is filled with water from the kitchen sink faucet, sample site "A". Sample site "A" did not test above the allowable level of 5 ppb, and is approved for consumption. L1 stated that she plans to remove the drinking fountain and cap off the water pipe that the fountain is attached to.

The following deficiency is being cited (see LIC809-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.

Exit interview conducted and report was reviewed with Licensee, Evelyn Contreras.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2022
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 08/24/2022 03:29 PM - It Cannot Be Edited


Created By: Amy Strother On 08/24/2022 at 03:04 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: LITTLE WILDFLOWERS PRESCHOOL, INC.
FACILITY NUMBER: 493009876

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/23/2022
Section Cited
CCR
101238(a)

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Buildings and Grounds 101238(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement was not met as evidenced by:
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Licensee has made the drinking fountain faucet temporarily inaccessible by shutting the water off. Licensee will remove the drinking fountain from the outdoor wall and cap of the pipe, removing it from use and submit photos of the correction to LPA Strother on or before 09/23/22.
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Based on record review, the facility had 1 drinking fountain faucet that exceeded the allowable levels of lead in the water. This is a potential health and safety risk to children in care.
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amy.strother@dss.ca.gov

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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:Alexis Hollon
LICENSING EVALUATOR NAME:Amy Strother
LICENSING EVALUATOR SIGNATURE:
DATE: 08/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/24/2022


LIC809 (FAS) - (06/04)
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