<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418183
Report Date: 09/11/2023
Date Signed: 09/11/2023 11:51:03 AM

Document Has Been Signed on 09/11/2023 11:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:BETTY'S CHILDREN'S ACADEMY - SCHOOL AGE PROGRAMFACILITY NUMBER:
013418183
ADMINISTRATOR:MCGHEE, BETTYFACILITY TYPE:
840
ADDRESS:11200 GOLF LINKS RD.UNIT FTELEPHONE:
(510) 430-8789
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/11/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Betty McGheeTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 09/11/2023 at 1100 AM Licensing Program Analyst (LPA), Randall Dunevant and Licensing Program Manager (LPM) Loretta Dyson conducted an announced case management inspection to follow up regarding a lead exceedance at the facility. LPA met with the owner, Betty Mcghee, to explain the purpose of today's inspection. The facility tested its drinking water for lead contamination on 7/9/2022 and again on 01/23/2023 and outlet sink faucet A/A30 school kitchen exceeded the acceptable amount of lead allowed at a childcare facility with a result of 6.8 PPB. The licensee failed to maintain a lead value at or below the Action Level for water lead testing resulting with values of 5.5ppb or greater for sink faucet A/A30 school kitchen. Water testing results identified with Action Level Exceedance as defined in WD section 101700.3 are not deemed safe to drink (See 809D for deficiency being cited today). Faucet was immediately removed from service and a do not use sign was placed on the outlet to ensure it was not used. Since that time the outlet and all piping has been replaced and a report reviewed on this date show exceedance is cleared. Results were posted for parents of children in care to access and director has sent all required documents to regional office.

Exit interview conducted, appeal rights were given, and report was reviewed with owner, Betty McGhee.

Appeal Rights and Report was provided.

Notice of Site Visit must remain posted for 30 days.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE: DATE: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 09/11/2023 11:51 AM - It Cannot Be Edited


Created By: Randall Dunevant On 09/11/2023 at 11:26 AM
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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BETTY'S CHILDREN'S ACADEMY - SCHOOL AGE PROGRAM
FACILITY NUMBER: 013418183

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/11/2023
Section Cited
CCR
101700.3(b)(2)

1
2
3
4
5
6
7
100700.3 (b)(2) that states “Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.
1
2
3
4
5
6
7
Outlet sink faucet A/A30 school kitchen room was removed from service and the outlet and piping has been replaced and retested to show no exceedence.
8
9
10
11
12
13
14
 This requirement was not met as evidenced by: Licensee failed to maintain a lead value at or below the Action Level for water lead testing resulting with values of 5.5 PPB or greater for outlet sink faucet A/A30 school kitchen. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Loretta Dyson
LICENSING EVALUATOR NAME:Randall Dunevant
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2