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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010032
Report Date: 11/10/2022
Date Signed: 11/10/2022 10:38:58 AM

Document Has Been Signed on 11/10/2022 10:38 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LITTLE ONES CHILDREN'S CENTERFACILITY NUMBER:
493010032
ADMINISTRATOR:ROBERT W. BRADYFACILITY TYPE:
850
ADDRESS:7789 HEALDSBURG AVENUETELEPHONE:
(707) 578-8363
CITY:SEBASTOPOLSTATE: CAZIP CODE:
95472
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 32DATE:
11/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Robert W. Brady - DirectorTIME COMPLETED:
10:38 AM
NARRATIVE
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On 11/10/2022 at 9:00 AM, Licensing Program Analyst (LPA), Fernandes-Goes made a case management inspection and met with Administrator, Robert Brady. The inspection was made in response to water lead testing results received from the California State Water Resource Control Board. The test results showed that the following faucets tested above the allowable level (5 ppb) of lead in the water: Sample Site, "C" – Classroom #4, 10.0 ppb.

The Center Administrator have made the faucet inaccessible by posting a “Temporarily closed for drinking” and “Only use for hand washing and dishes” posting on the sink and removing the sink from service and children are not able to access it. The water to the sink has not been turned off since it is being used for hand washing and dishes. The facility has purchased bottles of water and might start using a pitcher filled out with water from another classroom faucet which tested below the allowable level of (5ppb), and children in care are receiving drinking water by using cups to retrieve water from the pitcher. In addition, Administrator stated that the faucet will be replaced and retested by POC date and will submit plans regarding how that will be accomplished by 12/04/2022. Facility has posted testing results in the front board by sign in/sign out for parents and families to view at the facility and notification to all parents or guardians, including information about what has been done to date was provided around November 4Th, 2022.

The Center Administrator provided the External Water Sampling Self-Certification Form (LIC 9275), Child Care Center Sampling Checklist Form (LIC 9276), pictures, and Facility Sketch/Floor Plan (LIC 999) to LPA.



The following deficiency is being cited (see LIC 809D). Appeal Rights was provided. 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 Administrator, Robert Brady.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Carla Fernandes-Goes
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2022
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 11/10/2022 10:38 AM - It Cannot Be Edited


Created By: Carla Fernandes-Goes On 11/10/2022 at 10:04 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: LITTLE ONES CHILDREN'S CENTER
FACILITY NUMBER: 493010032

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2022
Section Cited

101700.3(b)(1)

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101700.3(b)(1) A result with values of 5.1 ppb or greater shall be deemed an Action Level Exceedance.
This requirement was not met as evidenced by:
Based on record review, the
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The center director has made the faucet temporarily inaccessible by posting an “Temporarily closed for drinking” and “Only use for hand washing and dishes” on the sink and removing the sink from service and children are not able to access it.
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facility had 1 faucet (Site "C") that exceeded that allowable levels of lead in the water (10.0 ppb). This is a potential health and safety risk to children in care.
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Facility has purchased bottles of water.Facility will be replacing the faucet and will have the water retested three weeks later and send results to CCL by 12/04/22.

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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:Alexis Hollon
LICENSING EVALUATOR NAME:Carla Fernandes-Goes
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2022


LIC809 (FAS) - (06/04)
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