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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 160401939
Report Date: 03/03/2023
Date Signed: 03/03/2023 11:35:17 AM

Document Has Been Signed on 03/03/2023 11:35 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:DOLORES HUERTA HEAD START CENTERFACILITY NUMBER:
160401939
ADMINISTRATOR:DE LA CRUZ, TAYLORFACILITY TYPE:
850
ADDRESS:700 6 1/2 AVETELEPHONE:
(559) 992-5200
CITY:CORCORANSTATE: CAZIP CODE:
93212
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 14DATE:
03/03/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Vanessa MendozaTIME COMPLETED:
12:00 PM
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On March 3, 2023 Licensing Program Analyst (LPA) Kari McWilliams conducted an unannounced case management inspection. LPA McWilliams met with Director Mendoza. The purpose of today’s inspection was to conduct a case management inspection and to notify the facility that there has been 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. LPA conducted a tour of the facility inside and out and a census was taken.

Fresno South Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from FACS and discussions with Director Mendoza it has been determined that there is an exceedance to outlet B and Outlet C in the facility. LPA McWilliams inspected outlets B and C and both outlets were observed to be outside drinking fountains that were impacted with 43 ppb(ALE) of lead and 65ppb (ALE) respectfully. Director Mendoza, has discontinued the use of both outlets by; POC. (See plan of correction for further corrective action 809D).

Director Mendoza has notified authorized representatives of this corrective action in both languages; English and Spanish.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809D). Director were provided a copy of the appeal rights.

An exit interview was conducted with Director Mendoza.

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: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2023
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 03/03/2023 11:35 AM - It Cannot Be Edited


Created By: Kari McWilliams On 03/03/2023 at 11:01 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: DOLORES HUERTA HEAD START CENTER
FACILITY NUMBER: 160401939

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/03/2023
Section Cited

101700.3

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California Lead Action Level at Child Care Centers (a)... lead in water at Child Care Centers is 5ppb....(1) A result with values of 5.5ppb or greater shall be deemed an Action Level Exceedance. (c) If testing indicates an Action Level Exceedance at any water outlet,...the water from that outlet is deemed not safe to drink... immediate response pursuant to section
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LPA observed water outlets to be inaccesible to children and another form of water is being provided outside for children in care. Director has posted the results of the exceedances and has notified parents in English and Spanish. Oulets B and C are being completely replaced and retested. Director will send the Department the results when completed.
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 101704 shall be required.
This requirement was not met by evidence by: Based on record review provided by FACS a result of (ALE) of 43 for outlet B and 65 for outlet C which is out of compliance over the allowable ALE 5.5ppb. This 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:Luisa Gavoutian
LICENSING EVALUATOR NAME:Kari McWilliams
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023


LIC809 (FAS) - (06/04)
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