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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418191
Report Date: 09/06/2023
Date Signed: 09/06/2023 01:55:28 PM

Document Has Been Signed on 09/06/2023 01:55 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ESCUELA BILINGUE INTERNACIONALFACILITY NUMBER:
013418191
ADMINISTRATOR:JENNIFER GALLOSOFACILITY TYPE:
850
ADDRESS:410 ALCATRAZ AVETELEPHONE:
(510) 653-3324
CITY:OAKLANDSTATE: CAZIP CODE:
94609
CAPACITY: 105TOTAL ENROLLED CHILDREN: 85CENSUS: 74DATE:
09/06/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Talia RomeroTIME COMPLETED:
03:45 PM
NARRATIVE
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On 09/06/2023 at 2:15 PM Licensing Program Analyst (LPA) A. Curry conducted an unannounced case management inspection to follow up on a lead exceedance at the facility. LPA met with director, Talia Romero, to explain the purpose of today's inspection. 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 outlet E Drinking Fountain Hall (Stair E). Water testing results identified with Action Level Exceedance as defined in WD section 101700.3 are not deemed safe to drink (See 809D). The facility indicated the water fountain will be removed and a wall mounted bottle filler will be installed by 09/30/2023.

Exit interview conducted, appeal rights were given, and report was reviewed with the Director Talia Romero.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 09/06/2023 01:55 PM - It Cannot Be Edited


Created By: Ashley Curry On 09/06/2023 at 01:34 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ESCUELA BILINGUE INTERNACIONAL
FACILITY NUMBER: 013418191

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/06/2023
Section Cited
CCR
101700.3

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Licensee 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.
This requirement is not met as evidence by:
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The facility indicated the fountain will be removed and a wall mounted bottle filler will be installed.

By 10/06/2023 the facility will submit proof that the water fountain was removed.
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Based on interview and record review the licensee did not comply with the section cited above as outlet E Drinking Fountain Hall (Stair E) exceeded the acceptable amount of lead allowed in a child care center, which poses a potential Health and Safety risk to persons 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:Loretta Dyson
LICENSING EVALUATOR NAME:Ashley Curry
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2023


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