566214313-1-25-2023-17-CC-SMAZ-CNETGD-20230125134259

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566214313
Report Date: 01/25/2023
Date Signed: 01/25/2023 01:43:16 PM

Document Has Been Signed on 01/25/2023 01:43 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	KID'S "N" THINGS CLUBHOUSE		FACILITY NUMBER:	566214313
ADMINISTRATOR:	CAROL ANN BARONA		FACILITY TYPE:	840
ADDRESS:	4191 COCHRAN STREET		TELEPHONE:	(805) 522-1011
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93063
CAPACITY: 28	TOTAL ENROLLED CHILDREN: 28	CENSUS: 0	DATE:	01/25/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Carol Barona		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 25, 2023 at 12:40 PM, Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced Case Management- Lead Testing/ Exceedance inspection to follow up on an Action Level Exceedance (ALE) reported to the Regional Office by Division of Drinking Water (DDW). LPA met with site director Carol Barona and advised her of the reason for the inspection. Together with the director, LPA toured the facility. At the time of the inspection there were 0 children in care. Director states the school-age program runs from 6AM- 8AM and again from 1:30PM- 7PM. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test. If the water testing results indicate that the facility has an ALE, an immediate response shall be required pursuant to section 101704, which may include remediation. The Regional Office received an ALE for one water outlet in this facility. The Center was notified by LPA of the results on 12/15/22 by phone. LPA advised director that location (B) had an ALE of 11 ppb. Director stated she was aware and the location is secured preventing children/staff from having access. Director stated a plan of correction packet was forwarded to LPA Michael Matthews in November of 2022. LPA advised director to please provide a copy on today's visit. During today's inspection, LPA toured the facility and inspected the water outlet in question. LPA observed the water fountain located in the hallway to be shut off completely. Director states the children bring their own water bottles from home and re-fill with the gallon jug as well as with the drinking fountain labeled as outlet A. Director also states the facility has a lease through the Shepard of the Valley Lutheran Church. Shepard of the Valley Church has decided to completely remove the entire drinking fountain from the wall and not replace it. Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KID'S "N" THINGS CLUBHOUSE	FACILITY NUMBER: 566214313
	VISIT DATE: 01/25/2023

NARRATIVE

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LPA provided a copy of PUB 515 and discussed the need for the Center to share this with families, discussed a plan of correction with the director and informed director the Plan of Correction for lead exceedances must include notification of parents and information about what has been done (their current response, such as water fixture put out of use, and bottled water provided) and remediation plans for all water outlets. LPA informed director that parents must acknowledge receipt of licensing report and POC.

LPA shared the following resources quick references:

Quick references:
· PIN 22-06-CCP - Lead Testing in Child Care Centers – Frequently Asked Questions
· PIN 21-21-CCP - Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370
· External Water Sampler Self-Certification Form (LIC 9275)
· Child Care Center Sampling Checklist Form (LIC 9276)
· CDSS Lead Toxicity Prevention and Water Testing Information page
· Resources listed on Sacramento State University, Office of Water Program website
· CCLD website: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

LPA advised Director that children must not have access to the outlet. Should the facility decide to use the outlet in the future for children in care, they must correct the ALE and retest to ensure they are staying in compliance.

No deficiency was cited during today's inspection.

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 was conducted and report was reviewed with the Director Carol Barona.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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