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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372000206
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:51:32 PM

Document Has Been Signed on 01/12/2023 01:51 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:FIRST PRESBYTERIAN CHURCH OF OCEANSIDE PRESCHOOLFACILITY NUMBER:
372000206
ADMINISTRATOR:CANDELORA WISENERFACILITY TYPE:
850
ADDRESS:2001 EL CAMINO REALTELEPHONE:
(760) 757-5120
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY: 160TOTAL ENROLLED CHILDREN: 235CENSUS: 58DATE:
01/12/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Candelora Wisenert DirectorTIME COMPLETED:
02:00 PM
NARRATIVE
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On January 12, 2023 at 1:00 PM, Licensing Program Analysts (LPA) Cindy Hamilton conducted a follow-up case management visit to the case management visit conducted on October 25, 2022 which was in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPA met with Candelora Wisenert Director who was informed of the reason for the visit.

LPA observed on the report provided by the SWRCB, Faucet T was identified as having high levels of lead. The faucet is located Fellowship Hall kitchen. Director stated that the faucet is not used by the preschool only by the church. Faucet T was taken out of service by the church until it was replaced after results were received. LPA observed Faucet T and it was in use but not for the children. LPA requested and observed Faucet T be placed out of service during the visit. LPA advised Director that Faucet T should not be used until the faucet is retested and returns a result at or below the Action Level. LPA also advised retesting results be provided to Community Care Licensing once received.

See LIC 809 D for cited deficiency in accordance with the California Code of Regulations Title 22, Division 12 written directives.

An exit interview was conducted with Candelora Wisenert Director. A copy of this report, appeal rights and a Notice of Site Visit was issued.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2023
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 01/12/2023 01:51 PM - It Cannot Be Edited


Created By: Cindy Hamilton On 01/04/2023 at 12:54 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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: FIRST PRESBYTERIAN CHURCH OF OCEANSIDE PRESCHOOL
FACILITY NUMBER: 372000206

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2023
Section Cited

101700.3(b)(1)

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(b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up...(1) A result with 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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Director stated faucet was replaced, but not retested. The Director will have Faucet T retested and provide results to CCL once available.
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LPA Hamilton received the facilities water testing results for faucets with an Action Level Exceedance higher than the allowable limit.
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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:Carlos Martinez
LICENSING EVALUATOR NAME:Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


LIC809 (FAS) - (06/04)
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