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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343607290
Report Date: 02/23/2023
Date Signed: 02/23/2023 12:55:51 PM

Document Has Been Signed on 02/23/2023 12:55 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:COSUMNES RIVER COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
343607290
ADMINISTRATOR:JENNIFER PATRICKFACILITY TYPE:
850
ADDRESS:8401 CENTER PARKWAYTELEPHONE:
(916) 691-7380
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: DATE:
02/23/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Jennifer PatrickTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Gagandeep Singh met with the director, Jennifer Patrcik, for a case management inspection due to the water lead testing result report. Purpose of the inspection was explained.

The facility had the water test conducted on January 04, 2023, for the lead. Based on the result report, three of the faucets had the 27 PPB, 21 PPB and 7.9 PPB lead in the water. LPA discussed with director that the Department's requirements are that the findings must be lower than 5.5 PPB. During the inspection, the director showed the faucets, which has exceedance, to the LPA. The faucets are located in the kitchen. The facility is no longer using the faucets for cooking. Director showed a different faucet to the LPA that is being used for cooking. Director stated that the building maintenance has already started the process to resolve the lead issue for the faucets in the kitchen.

Copy of this report was reviewed and provided to the Director. See next page for written directive provided today. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2023
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 02/23/2023 12:55 PM - It Cannot Be Edited


Created By: Gagandeep Singh On 02/23/2023 at 11:58 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: COSUMNES RIVER COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 343607290

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2023
Section Cited

101700.3(b)(1)

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California Lead Action Level at Child Care Centers. b) Testing results with fractional ppb readings of 0.5 or greater shall be rounded up to the nearest whole number, before comparing to the Action level. 1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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During inspection, LPA observed the faucets, that has exceedance, are located in the Kitchen. Per director, the facility is no longer using the faucets for the cooking and building maintenance has started the process to resolve the lead issue from the water.
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This requirement is not met as evidenced by: Based on results of a test conduct on a faucet on January 04, 2023 indicated three faucets had 27,21 and 7.9 ppb in the faucet water, which exceed 5.5 ppb requirement. This is a potential risk to the health and safety of children in care if not corrected.
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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:Natalie Dunaway
LICENSING EVALUATOR NAME:Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2023


LIC809 (FAS) - (06/04)
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