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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700614
Report Date: 06/12/2024
Date Signed: 06/13/2024 12:44:27 PM

Document Has Been Signed on 06/13/2024 12:44 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ENLIGHT ACADEMYFACILITY NUMBER:
015700614
ADMINISTRATOR/
DIRECTOR:		SHAHEIDARI, ELHAMFACILITY TYPE:
850
ADDRESS:7500 AMARILLO ROADTELEPHONE:
(408) 614-9961
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 5DATE:
06/12/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Director, Elham Shaheidari TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Jyoti Saini visited the facility unannounced and conducted a Case Management visit to discuss recent lead testing results. The LPA met with the Director, Elham Shaheidari.

On 05/14/2024, samples were collected from four faucets within the facility. The office sink was recorded as Action Level Exceedance out of the four faucets. The test results showed a 7.4 ppb level of lead. However, the facility never used this faucet with an ALE for drinking or food preparation. The facility has opted to repair/replace the water outlet. LPA advised that a follow-up water sample should be taken following the lead testing protocol. LPA obtained the retesting results of the samples collected on 5/14/2024 and all other required documents.

A Type B Deficiency was issued today; see LIC 809D, and the citation was cleared during the inspection.

A Notice of Site Visit was given and must be posted for 30 days.

Appeal rights were given and reviewed.

An exit interview was conducted, and the report was reviewed with the director, Elham Shaheidari.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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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Document Has Been Signed on 06/13/2024 12:44 PM - It Cannot Be Edited


Created By: Jyoti Saini On 06/13/2024 at 12:22 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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: ENLIGHT ACADEMY
FACILITY NUMBER: 015700614

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2024
Section Cited

101.700.3(B)(1)

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101700.3(b)(1)A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement is not met as evidenced by:
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The facility is in the process of remediating the exceedance. Since the facility has opt to repair/replace the water outlets, a follow up water sample shall be taken following the lead testing protocol.
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Based on observations, interviews, and record reviews, the facility did not comply with the section cited above. Licensee failed to maintain a lead value at or below the Action Level for water lead testing with values of 5.5 ppb or greater for office sink, 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:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2024


LIC809 (FAS) - (06/04)
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