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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503602084
Report Date: 01/16/2025
Date Signed: 01/16/2025 12:36:33 PM

Document Has Been Signed on 01/16/2025 12:36 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LIGHTHOUSE PRESCHOOLFACILITY NUMBER:
503602084
ADMINISTRATOR/
DIRECTOR:		BENSON, CINDYFACILITY TYPE:
850
ADDRESS:913 FLOYD AVE.TELEPHONE:
(209) 557-0458
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 38DATE:
01/16/2025
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Director Cindy BensonTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On 01/16/2025 Licensing Program Analyst (LPA), Xona Xayavong conducted an unannounced case management – lead testing/exceedance inspection. LPA met with Director Cindy Benson. The purpose of today's inspection is to follow-up on the lead testing result.

On today’s visit, LPA observed the two sinks faucet located in Building D, drinking fountain near the library, and one sink faucet in Building B. On 4/17/2024, Director Cindy Benson received lead sampling test report from California Rural Water Association (CRWA) that was collected on 3/27/2024. The lead sampling test report showed sink faucet in Building D 503602084 B showed less than 1.0 ppbs, sink faucet in Building D 503602084 B30 showed less than 1.0 ppbs, drinking fountain near the library 503602084 C showed less than 1.0 ppbs, and sink faucet in Building B 503602084 D showed less than 1.0 ppbs. LPA also received LIC 9276, LIC 9275, and LIC 999 from the report. No exceedance was found, which means that no further action is required. The facility is aware that they will need to retest their outlets every 5 years to comply with the Written Directives.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations, no deficiency is being cited. Director Cindy Benson was provided a copy of appeals rights. An exit interview was conducted with, Director Cindy Benson. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Xona Xayavong
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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