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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408909
Report Date: 10/26/2023
Date Signed: 10/26/2023 02:30:12 PM

Document Has Been Signed on 10/26/2023 02:30 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:SUNSHINE PLAYSCHOOLFACILITY NUMBER:
073408909
ADMINISTRATOR:GRAY, KAITLINFACILITY TYPE:
850
ADDRESS:5151 ARGYLE ROADTELEPHONE:
(510) 307-4365
CITY:EL SOBRANTESTATE: CAZIP CODE:
94803
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 21DATE:
10/26/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:GRAY, KAITLIN TIME COMPLETED:
02:45 PM
NARRATIVE
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On 10/26/23 at 01:00PM Licensing Program Analyst (LPA) Nyeesha Blount conducted a unannounced Case management for Lead Testing/ exceedance at Sunshine Playschool. LPA met with Director Gray, Kaitlin and explained the purpose of today's inspection.

LPA toured the facility for a health and safety check. The Sink faucet is located in the staff room exceeded the acceptable amount of lead allowed in a child care center. The Director stated that facility has not used the sink since the testing and would like to remediate by replacing the sink. the sink faucet is tapped off and is located in a room that is OFF LIMITS made inaccessible to children in care.

The following deficiency was observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Gray, Kaitlin.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2023
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 10/26/2023 02:30 PM - It Cannot Be Edited


Created By: Nyeesha Blount On 10/26/2023 at 01:46 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: SUNSHINE PLAYSCHOOL
FACILITY NUMBER: 073408909

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/26/2023
Section Cited

101700.3

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Licensee shall maintain a lead value at or below the Action Level of 5ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.
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The facility will permanently cease outlet or remeditae by replacing the outlet and retest to by POC date of November 25, 2023. LPA will be notified when the changes have been made via email.
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Based on recored review the licensee did not comply with the section cited above as there was a small sink in the facility break room that has a lead exceedance, which poses a potiential 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:Mayla Mendoza
LICENSING EVALUATOR NAME:Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2023


LIC809 (FAS) - (06/04)
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