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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600969
Report Date: 01/11/2023
Date Signed: 01/11/2023 12:18:02 PM

Document Has Been Signed on 01/11/2023 12:18 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:CALVIN CHRISTIAN PRESCHOOLFACILITY NUMBER:
376600969
ADMINISTRATOR:LYNN SOCHOWSKI LAYMANFACILITY TYPE:
850
ADDRESS:1868 N. BROADWAYTELEPHONE:
(760) 520-8431
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 89TOTAL ENROLLED CHILDREN: 0CENSUS: 49DATE:
01/11/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:26 AM
MET WITH:Sonya Downs- DirectorTIME COMPLETED:
12:25 PM
NARRATIVE
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On January 11, 2022 at 11:30 AM, Licensing Program Analysts (LPAs) Cindy Hamilton and Nasha King, 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). LPAs met with Sonya Downs- Director who was informed the reason for the visit.

During the visit, LPAs toured the facility and observed on the report provided by the SWRCB, Faucet H was identified as having high levels of lead. The faucet is located in Room #2. Director stated that the faucet was only used for teacher hand washing and cleaning of supplies and not for drinking water or food preparation. Director stated the faucet was immediately turned off, properly labeled as out of service and still not in use. The faucet has been replaced with non-lead faucet and retested on January 5, 2023 . Director advised she does not have the results from the January 5th testing yet.

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 Sonya Downs- 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: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2023
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 01/11/2023 12:18 PM - It Cannot Be Edited


Created By: Cindy Hamilton On 01/04/2023 at 11:45 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CALVIN CHRISTIAN PRESCHOOL
FACILITY NUMBER: 376600969

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
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, retested and results pending. Director will advise CCL of results once received.
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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: 01/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2023


LIC809 (FAS) - (06/04)
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