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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360905326
Report Date: 05/20/2024
Date Signed: 05/21/2024 02:20:12 PM

Document Has Been Signed on 05/21/2024 02:20 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHRIST LUTHERAN PRESCHOOL & KINDERGARTENFACILITY NUMBER:
360905326
ADMINISTRATOR/
DIRECTOR:		STACEY STRASSERFACILITY TYPE:
850
ADDRESS:5500 FRANCIS AVENUETELEPHONE:
(909) 627-1433
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY: 90TOTAL ENROLLED CHILDREN: 38CENSUS: 23DATE:
05/20/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Stacey Strasser - Director TIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Rachel Zeron conducted a case management inspection due to required lead testing requirements based on lead testing results received on the facility. LPA toured the facility, took census and met with Stacey Strasser, Director to further discuss lead results received and measures taken for remediation of lead exceedances.

During the inspection, LPA toured and observed the following water outlets identified with lead exceedances: outlet P (tested at 6.8 ppb) was identified; Outlet P is a water fountain that is located on the playground, right outside the Yellow room. LPA verified that the required signage for cessation of use was in place.

Facility implemented the following plan of action until formal remediation can be completed on water outlet P. The Director covered water outlet, posted required signage for non-use for drinking and will complete repairs to the outlets affected. LPA observed notification of lead results posted in the main lobby on the parent board. Children bring their own water bottle from home and/or use cups that the facility provides, a container with filtered water is kept in each classroom.

Due to facility water outlet testing for lead exceedance level above approved lead levels, a deficiency has been cited. See LIC809D.


SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHRIST LUTHERAN PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 360905326
VISIT DATE: 05/20/2024
NARRATIVE
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Additionally, the following resources were discussed and provided from PIN 21-21-CCP dated July 28, 2021:

101700.6 Grant Funding for Qualifying Child care Centers

(a) Senate Bill 862, Chapter 449, Statutes of 2018 allocated $5 Million to the State Water Resources Control Board for testing and remediation of lead in the drinking water of Child Care Centers based on the following criteria:

(1) Those that serve children zero to five years of age, with the highest priority for Child Care Centers that provide care for children zero to three years of age.

(2) Those that have 50 percent or more of their registered children who receive subsidized care.

(3) Those that operate only one facility.

(b) To determine a Child Care Center’s eligibility for possible funding the Department will provide access to a link to an online eligibility form located on the Department’s website and on Sacramento State’s Office of Water Programs website.

(1) A Child Care Center interested in financial assistance shall complete the eligibility form, which shall include instructions for completing and returning it, prior to receiving any grant funding for which it may qualify. To determine a Child Care Center’s eligibility for possible funding, the provider will need to complete an online eligibility form available at Office of Water Programs’ website

An exit interview was conducted, LPA provided Stacey Strasser with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years.

Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/21/2024 02:20 PM - It Cannot Be Edited


Created By: Rachel Zeron On 05/20/2024 at 02:57 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHRIST LUTHERAN PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 360905326

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/20/2024
Section Cited
CCR
101700.3(b)(1)

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California Lead Action Level at Child Care Centers 101700.3 (b)(1): A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement is not met as evidence by:
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Director is waiting for the replacement of the water fountain outlet P, once replaced and retested, Director will submit new test results once received by POC date.
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Based on records review of required lead testing, the facility had lead values of 5.5 ppb or above on water outlet: P (6.8 ppb).

This is a potential 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:Aaron Ross
LICENSING EVALUATOR NAME:Rachel Zeron
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2024


LIC809 (FAS) - (06/04)
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