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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810185
Report Date: 01/31/2023
Date Signed: 01/31/2023 09:32:54 AM

Document Has Been Signed on 01/31/2023 09:32 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FEOC RICHARD KEYES HEAD STARTFACILITY NUMBER:
103810185
ADMINISTRATOR:MARIA ISABEL MARMOLEJOFACILITY TYPE:
850
ADDRESS:1620 W FAIRMONT AVETELEPHONE:
(559) 263-1205
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 44DATE:
01/31/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Director, Guadalupe AlcortaTIME COMPLETED:
09:45 AM
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On 01/31/23 Licensing Program Analyst (LPA) Caroline Harris conducted an unannounced case management inspection. LPA met with Director, Guadalupe Alcorta for the purpose of conducting a case management inspection, regarding a lead exceedance referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

Fresno Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from Child Care Center Lead Sampling and test results from Moore Twining Associates, Inc for licensee #103810185 an outlet is impacted with an (ALE) of 6.2 ppb in the adult faucet in the staff kitchen named outlet A. This result indicates out of compliance over (ALE) 5.5 ppb. (See Plan of correction for further corrective action 809D). The faucet has been replaced and is in the process of being flushed for re-testing. Director agrees to continue with the resampling process for an action level result of under 5.5 ppb for compliance with a Certified Sampler.

Director stated staff are provided bottled water in the staff kitchen. Potable water is also made available to visitors during hours of operation. Children do not use this faucet. Facility has posted results for parents to review Per PIN 21-21-1 CCP WD 101703 (b). In addition parents and guardians were notified by letter and verbally of the (ALE ) Per PIN 21-21-1 CCP WD 101704 (b)(3).

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, a type B deficiency is being cited: (see next page, 809 D). The director was provided a copy of appeal rights. An exit interview was conducted. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2023
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 01/31/2023 09:32 AM - It Cannot Be Edited


Created By: Caroline Harris On 01/31/2023 at 09:15 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FEOC RICHARD KEYES HEAD START
FACILITY NUMBER: 103810185

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2023
Section Cited

101700.3(a)(b)

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California’s Action Level for lead in water at Child Care Centers is 5 ppb. Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. Testing results with fractional ppb readings of less than 0.5 ppb shall be rounded down to the nearest whole number, before comparing to the Action Level. (1)
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Director agrees to submit evidence of the re-testing results on outlet A in the staff kitchen testing at or below Action Level by POC due date 02/28/23.
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A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. (2) 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. (c) If testing indicates an Action Level Exceedance at any water outlet, the water from that outlet is deemed not safe to drink and an immediate response pursuant to section 101704 shall be required. This requirement was not met evidence by: Based on record review from Child Care Center Lead Sampling and test results from Moore Twining Associates, Inc indicating (ALE) of 6.2 ppb in outlet A. These results indicate out of compliance over (ALE) 5.5 ppb, which poses a potential health, safety or personal rights 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:Cynthia Brannon
LICENSING EVALUATOR NAME:Caroline Harris
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2023


LIC809 (FAS) - (06/04)
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