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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561708173
Report Date: 10/07/2022
Date Signed: 10/07/2022 02:48:58 PM

Document Has Been Signed on 10/07/2022 02:48 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VENTURA BRANCH - POINSETTIA ELEMENTARYFACILITY NUMBER:
561708173
ADMINISTRATOR:JULIE O'BRIENFACILITY TYPE:
840
ADDRESS:350 N. VICTORIA AVE.TELEPHONE:
(805) 654-0620
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: DATE:
10/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:19 PM
MET WITH:Amanda PinedoTIME COMPLETED:
03:19 PM
NARRATIVE
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On October 7, 2022 at 1:19 PM, Licensing Program Analyst (LPA) Rona Chavez conducted an unannounced Case Management inspection to follow-up on an Action Level Exceedance (ALE) reported to the Regional Office by Division of Drinking Water (DDW). LPA met with Site Director, Amanda Pinedo and advised her the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were 36 children in care at the time of the inspection.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five (5) years after the date of the first test. If the water testing results indicate that the facility has an ALE, an immediate response shall be required pursuant to section 101704, which may include remediation.

The Regional Office received an ALE for two (2) water outlets in this facility. The Center was notified by LPM Mingle of the results on September 8, 2022 by phone. LPM advised Director that location (G) had an ALE of 6.3 ppb and location (H) had an ALE of 6.3 ppb. Director advised that she will use purchased 5 gallon water bottles for the children in care.

On 9/25/2022 LPA Chavez received an email from Director of Risk Management with retest results. Location (G) retested as location (A) had and ALE of 6.9 ppb and location (H) retested as location (B) had a result of 5.0 ppb. Director provided picture of removed outlet (A).

Continued on 809-C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
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.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VENTURA BRANCH - POINSETTIA ELEMENTARY
FACILITY NUMBER: 561708173
VISIT DATE: 10/07/2022
NARRATIVE
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During today’s inspection, LPA toured the entire facility and inspected the outlets in question. LPA observed that fixture at location (B) was available for use and location (A) has been removed. Site Director advised that the outlets were in use on the school grounds prior to testing.

LPA advised the testing report must be posted and parents/authorized representative informed of the ALE.

LPA provided a copy of PUB 515 and discussed the need for the Center to share this with families, discussed a plan of correction with the director and informed director the Plan of Correction for lead exceedances must include notification of parents and information about what has been done (their current response, such as water fixture put out of use, and bottled water provided) and remediation plans for all water outlets. LPA informed Director that parents must acknowledge receipt of licensing report and POC.

LPA's shared the following resources quick references:

Quick references:
· PIN 22-06-CCP - Lead Testing in Child Care Centers – Frequently Asked Questions
· PIN 21-21-CCP - Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370

A type B deficiency is being cited today. See attached 809D.

Exit interview conducted and report was reviewed with the Director. Appeal rights were provided to Director.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
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
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Document Has Been Signed on 10/07/2022 02:48 PM - It Cannot Be Edited


Created By: Rona Chavez On 10/07/2022 at 02:20 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VENTURA BRANCH - POINSETTIA ELEMENTARY
FACILITY NUMBER: 561708173

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

101700.3(b)(1)

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101700.3 California Lead Action Level at Child Care Centers
(b) Testing results with fractional ppb readings of 0.5 ppb or greater ... the Action Level.
(1) A result with values of 5.5 ppb ... shall be deemed an Action Level Exceedance.
This requirement is not met as evidenced by:
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Facility has taken the following steps: Shutoff and labeled the two (2) outlets, replaced and retested the outlets. (1) Outlet removed and LPA was notified of passing test result. During inspection LPA viewed removed outlet. Center will notify parental notification of the water testing results.
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Facility conducted water lead testing and had two (2) outlets exceeded the action level exceedance per regulations. This poses a potential risk to the health and safety of the children 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:Ana Tolentino
LICENSING EVALUATOR NAME:Rona Chavez
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


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