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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343604948
Report Date: 10/26/2022
Date Signed: 10/26/2022 03:11:34 PM

Document Has Been Signed on 10/26/2022 03:11 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
343604948
ADMINISTRATOR:DONYALE ROBERTSFACILITY TYPE:
850
ADDRESS:7901 LAGUNA BOULEVARDTELEPHONE:
(916) 691-3800
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 59DATE:
10/26/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Donyale RobertsTIME COMPLETED:
03:30 PM
NARRATIVE
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On 10/26/2022, Licensing Program Analyst (LPA) Katy Maestas conducted a field visit to the Center for the purpose of a case management inspection. LPA arrived at the Center and was met by the Assistant Director Juanita Belen (D2). Director Donyale Roberts (D1) arrived shortly after at approximately 2:30 PM. LPA disclosed the purpose of the inspection and was granted entrance into the facility by D2. LPA toured the Center; D2 accompanied LPA for the entirety of the tour. LPA observed 12 infants being supervised by 3 adults and 47 preschool-aged children being supervised by 5 adults during nap time. LPA determined through accessing Guardian that all required adults are background cleared.

LPA is following-up on a lead testing report, dated 10/06/2022, which tested the water used for both consumption and hand washing in the facility. LPA was notified of the lead testing report on 10/20/2022 via mail. The report revealed that 4 water outlets (bathroom sinks) had elevated levels of lead. D2 stated that these water outlets were never used for consumption and only for hand washing. LPA verified that the affected water outlets are not in use; sinks were taped off and marked "closed." Both classrooms contain additional sinks that may be utilized until the 4 faucets are repaired. D2 stated that water for consumption is from the kitchen sink which tested as having NO elevated levels of lead. D1 stated that EMCOR will repair the water outlets and that the water will be re-tested.

As a result of the water testing positive for elevated levels of lead, a deficiency was cited on subsequent page 809D page. An exit interview was conducted and the report was reviewed with D1. Licensee Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
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 10/26/2022 03:11 PM - It Cannot Be Edited


Created By: Nola Maestas On 10/26/2022 at 03:00 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 343604948

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/27/2022
Section Cited
CCR
101700.3(b)(1)

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Lead Testing (b)(1) A result which values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by:
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During today's visit LPA observed that the affected water outlets are not in use. Director will have the sinks repaired and the water re-tested. Director will report the new results to LPA.
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The water report dated 10/06/2022 revealed that the facility had elevated levels of lead in 4 water outlets. This is a potential health and safety risk to the children 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:Jeanne Smith
LICENSING EVALUATOR NAME:Nola Maestas
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022


LIC809 (FAS) - (06/04)
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