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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503808887
Report Date: 09/28/2023
Date Signed: 09/28/2023 12:03:00 PM

Document Has Been Signed on 09/28/2023 12:03 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SMALL WORLD CHRISTIAN SCHOOLFACILITY NUMBER:
503808887
ADMINISTRATOR:PADILLA, MIRIAMFACILITY TYPE:
850
ADDRESS:1024 6TH STREETTELEPHONE:
(209) 523-4388
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY: 74TOTAL ENROLLED CHILDREN: 48CENSUS: 23DATE:
09/28/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Debbie MartinezTIME COMPLETED:
12:15 PM
NARRATIVE
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On 09/27/2023 Licensing Program Analyst (LPA) Yesenia Fierro conducted an unannounced case management inspection. LPA Fierro met with Director Debbie Martinez. The purpose of today’s inspection was to conduct a case management inspection and to notify the facility that there has been a lead exceedance referred to as an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility. LPA conducted a tour of the facility inside and out and a census was taken.

Fresno North Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on records reviewed from Cal Rural Water and discussions with Director Debbie Martinez it has been determined that there is an exceedance to outlets 503808887 A, 503808887 S, 503808887 U, 503808887 V, 503808945 DD, 503808945 G, and 503808945 H in the facility. LPA Fierro inspected outlets:

503808887 A was observed to be a kitchen sink faucet located inside the gym in the infant building that was impacted with amount of lead 10.00 (ALE) of lead.
503808887 S was observed to be a kitchen sink faucet located inside the preschool building, that was impacted with amount of lead 7.50 (ALE) of lead.
503808887 U was observed to be an indoor water fountain located near the preschool kitchen, that was impacted with amount of lead 15.00 (ALE) of lead.
503808887 V was observed to be an outside water fountain, that was impacted with amount of lead 9.70 (ALE) of lead.
503808945 DD was observed to be a gym bathroom sink faucet, that was impacted with amount of lead 21.00 (ALE) of lead.
503808945 G was observed to be a gym bathroom sink faucet, that was impacted with amount of lead 33.00 (ALE) of lead.
503808945 H was observed to be a gym bathroom sink faucet. that was impacted with amount of lead 9.40(ALE) of lead.
CON'T 809-C
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SMALL WORLD CHRISTIAN SCHOOL
FACILITY NUMBER: 503808887
VISIT DATE: 09/28/2023
NARRATIVE
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Director Debbie Martinez has discontinued the use of all exceeding outlets by, making all outlets inaccessible by wrapping them tight with plastic bags. Outlets 503808887 A, 503808887 U, 503808887 V, 503808945 DD, 503808945 G, and 503808945 H will be capped off and discontinued. Outlet 503808887 S will be replaced. Once it is replaced the outlet will be flushed and retested prior to use.

(See plan of correction for further corrective action 809D). Director Debbie Martinez will notify authorized representatives of this corrective action in both languages, English and Spanish to all parents via a letter.

Facility will continue to provided water to the children in care from Alhambra water service. Facility also has 10 cases of bottle water stored in case of an emergency.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, A type B deficiency is being cited: (see next page, 809D). Director Debbie Martinez were provided a copy of the appeal rights. An exit interview was conducted with Director Debbie Martinez.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/28/2023 12:03 PM - It Cannot Be Edited


Created By: Yesenia Fierro On 09/28/2023 at 11:08 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SMALL WORLD CHRISTIAN SCHOOL
FACILITY NUMBER: 503808887

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/28/2023
Section Cited

101700.3

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(a)California’s Action Level for lead in water at Child Care Centers is 5ppb.(b) Testing results with fractional ppb readings of 0.5ppb or greater shall be rounded up..., before comparing to the Action Level. (1) A result with values of 5.5ppb...Action Level Exceedance. (c) If testing indicates an Action Level
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LPA observed outlets have been made inaccessible by wrapped plastic bags. Outlets 503808887 A, 503808887 U,503808887 V,503808945 DD,503808945 G and 503808945 H
will be capped off. Outlet 503808887 S will be replaced and flushed. Director Debbie Martinez confirms the results will
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Exceedance at any water outlet...This requirement was not met by evidence by: Based on record review provided by CRWA result, of 10.00 (ALE) for outlet 503808887 A, 7.50 (ALE) for outlet 503808887 S, 15.00 (ALE) for outlet 503808887 U, 9.70 (ALE) for outlet 503808887 V
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be sent in by (POC) November 30, 2023. Director Debbie Martinez confirmed facility uses Alhambra bottle services to provide drinking water to children in care. Director Debbie Martinez will submit Alhambra bottle service contact to CCL by October 5, 203. Director confirmed that parents/guardians will be notified of the exceedance via letter.
Type B
09/28/2023
Section Cited
101700.3

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21.00 (ALE) for outlet 503808945 DD, 33.00 (ALE) for outlet 503808945 G, and 9.40(ALE) for outlet 503808945 H. Which are out of compliance over the allowable ALE 5.5ppb. This poses a potential health, safety or personal rights 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:Rene Mancinas
LICENSING EVALUATOR NAME:Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2023


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