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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010212589
Report Date: 12/07/2022
Date Signed: 12/07/2022 03:38:24 PM

Document Has Been Signed on 12/07/2022 03:38 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:FREMONT CHRISTIAN PRESCHOOLFACILITY NUMBER:
010212589
ADMINISTRATOR:JIMENEZ, NATHANIELFACILITY TYPE:
850
ADDRESS:4760 THORNTON AVENUETELEPHONE:
(510) 744-2260
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 197TOTAL ENROLLED CHILDREN: 100CENSUS: 80DATE:
12/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Nathaniel JimenezTIME COMPLETED:
03:45 PM
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On December 07, 2022 at approximately 2:05pm Licensing Program Analyst (LPA) R. Haderer arrived for a scheduled meeting with site director Nathaniel Jimenez to discuss the results of the recent lead test. There were 80 children in care and 18 fingerprint and associated staff present. The center is in ratio today.

On October 27, 2022 lead test samples were taken for all water locations in the school that are for human consumption. There were total of 13 locations tested on the campus: 2 food prep sink fountains; 8 sink fountains; 3 sink faucets.

On October 28, 2022 the samples were analyzed and test results showed the lead levels were all acceptable with the exception of one sink fountain in classroom P-7 which was found to be 7.72ppb. A result with values of 5.5 ppb or greater is deemed an Action Level Exceedance (ALE) and requires an immediate plan of correction.

All classroom drinking fountains in the school have not been in use for many years, the school uses filtered water dispensers. As a level of precaution, all drinking fountains located in the classrooms at the school were immediately and permanently removed. Since the fountains have not been used for many years, and they were all removed, at this time there is no deficiency to correct.

LPA collected the LIC9275 Water Sampler Self-Certification; LIC9276 Child Care Center Sampling checklist; LIC999 facility sketches; photos of locations tested and the final lab report and analyses.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the site director Nathaniel Jimenez.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2022
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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