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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215196
Report Date: 11/21/2022
Date Signed: 11/21/2022 01:44:13 PM

Document Has Been Signed on 11/21/2022 01:44 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:PHOENIX RANCH SCHOOL & CAMP (WEST CAMPUS)FACILITY NUMBER:
566215196
ADMINISTRATOR:VICTORIA DE LEONFACILITY TYPE:
850
ADDRESS:4974 COCHRAN AVE.TELEPHONE:
(805) 527-7764
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY: 225TOTAL ENROLLED CHILDREN: 225CENSUS: 116DATE:
11/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Victoria De LeonTIME COMPLETED:
11:40 AM
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On November 21, 2022 at 10:50 AM, Licensing Program Analyst (LPA) Francisco Pedroza 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 facility Director, Victoria De Leon and advised her the purpose of the inspection. Director provided LPA a tour of the facility. There were 116 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 one (1) water outlet in this facility. The Center was notified by LPA Pedroza of the results on November 14, 2022 by phone. LPA advised Director that location "G" had an ALE of 130.0 ppb. Director advised the location had been secured preventing children/staff from having access. Director asked if the facility is allowed to use the sink for hand washing only. LPA recommended that they look into having the faucet repaired, but that as long as it is only used for hand washing and not drinking/cooking it is okay to use.

During today’s inspection, LPA toured the facility and inspected the outlet in question. LPA observed that the one (1) outlet is a sink that staff are using for washing their hands. Children wash their hands in the children restroom. Director advised the facility does not use the outlet for drinking or cooking water.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2022
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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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: PHOENIX RANCH SCHOOL & CAMP (WEST CAMPUS)
FACILITY NUMBER: 566215196
VISIT DATE: 11/21/2022
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 LPA advised Director and teachers in the classroom that the faucet can only be used for hand and dish washing only. Additionally, staff should not rinse fruits or vegetables with the faucet as well. Director advised they are looking to have their maintenance staff repair or replace the faucet. LPA advised Director that once the repair is completed, they will have to retest to ensure the ALE has been corrected. LPA reviewed the Provider Information Notice (PIN) 21-21-CCP "Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370."

Per PIN 21-21-CCP, the following outlet locations should be sampled: cold water faucets and fountains, cold water side of single-handle and dual-handle faucets that dispense both hot and cold water, filtered water dispensers, and water dispensed by refrigerators used for drinking and cooking water. The facility provides water for children/staff in the facility purchased from a local vendor.

LPA provided a copy of PUB 515 and 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

No deficiency was cited during today's inspection.

Exit interview conducted and report was reviewed with the Director.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2022
LIC809 (FAS) - (06/04)
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