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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483002938
Report Date: 11/08/2022
Date Signed: 11/08/2022 02:08:13 PM

Document Has Been Signed on 11/08/2022 02:08 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:CHILDTIME CHILDREN'S CENTER - PRESCHOOLFACILITY NUMBER:
483002938
ADMINISTRATOR:CARI HUFFFACILITY TYPE:
850
ADDRESS:1201 BURTON DRIVETELEPHONE:
(707) 455-1700
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 96TOTAL ENROLLED CHILDREN: 56CENSUS: 42DATE:
11/08/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Assistant Director HeatherTIME COMPLETED:
02:08 PM
NARRATIVE
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On 11/08/2022 at 12:50pm, Licensing Program Analyst (LPA), Elpidia Hernandez Torres made a case management inspection and met with assistant director Heather. The inspection was made in response to water lead testing results received. The test results showed that the following faucets tested above the allowable level (5 ppb) of lead in the water:

Faucet “E” – Laundry Room Sink, 11.1 ppb, and Faucet “U” – Pre-K Restroom Sink 2, 7.84 ppb

The staff have made the faucet inaccessible by placing bag/item over faucet, posting signs not to use. Children in care are receiving drinking water from the sinks in the pre-k classroom, and a water container which is filled from the pre-k classroom sinks not in the restroom.

The following deficiency is being cited (see LIC 809D). A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with assistant center director.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2022
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 11/08/2022 02:08 PM - It Cannot Be Edited


Created By: Elpidia Hernandez Torres On 11/08/2022 at 01:39 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: CHILDTIME CHILDREN'S CENTER - PRESCHOOL
FACILITY NUMBER: 483002938

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/22/2022
Section Cited
CCR
101700.3(b)(1)

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101700.3(b)(1) California Lead Action Level at Child Care Centers - , “A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.”
This was not met as evidence by. . . .
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Center taped off both sinks and placed signs to block both staff and children from using the sinks. Center submitted pictures showing both sinks were taped off. Children have access to drinking water by use of the sinks inside the pre-k classroom not in the restroom.
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. . . based on record review, the facility had two faucets that exceeded that allowable levels of lead in the water. This is a potential health and safety risk to 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:Leslie Lepori
LICENSING EVALUATOR NAME:Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2022


LIC809 (FAS) - (06/04)
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