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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570306437
Report Date: 01/26/2023
Date Signed: 01/26/2023 09:26:33 AM

Document Has Been Signed on 01/26/2023 09:26 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:CENTER FOR CHILD AND FAMILY STUDIESFACILITY NUMBER:
570306437
ADMINISTRATOR:TWIBELL, KELLYFACILITY TYPE:
850
ADDRESS:238 FIRST STREETTELEPHONE:
(530) 752-2888
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 43DATE:
01/26/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kelly TwibellTIME COMPLETED:
09:40 AM
NARRATIVE
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Licensing Program Analyst (LPA) Salene Mayberry met with Director Kelly Twibell for an unannounced Case Management Inspection. LPA observed 43 children being cared for by 9 staff members.

The purpose of today’s inspection was to follow up regarding a water sampling that indicated Action Level Exceedances (ALEs) in three septate outlets tested for lead levels on 12/16/2022. On 01/11/2023 the facility was notified that water levels were in exceedance of 5 parts per billion in a drinking fountain (outlet H), and two separate sinks (outlet N and E). Outlets H and N were in classrooms associated with license #570306437. Outlet E was in a classroom associated with license #570311412. All exceedances are being addressed in this report.

Since receiving the notification Director advised that the fixtures for outlets N and E were replaced on 1/18/23. In addition, Director advised that these outlets had not been used for drinking or preparing food for the three years they had been using the rooms, and that they had only used them for hand washing and cleaning toys. Additionally, outlet H was turned off and then the fixture was capped as the kids bring their own water and they do not use that drinking fountain.

LPA informed Director that Grant funding for testing and remediation is available and information can be found in Provider Information Notice (PIN) 21-04-CCP.

A Type B deficiency was cited on the subsequent page (LIC809-D) of this report.

An Exit interview conducted, and the report was reviewed and provided to Director. LPA posted the Notice of Site Visit and Director acknowledges it must remain posted for 30 days. A Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Salene Mayberry
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 01/26/2023 09:26 AM - It Cannot Be Edited


Created By: Salene Mayberry On 01/26/2023 at 09:18 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: CENTER FOR CHILD AND FAMILY STUDIES
FACILITY NUMBER: 570306437

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/03/2023
Section Cited

101700.3(c)

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101700.3 California Lead Action Level at Child Care Centers (c) If testing indicates an...Exceedance at any water outlet, the water from that outlet is deemed not safe to drink and an immediate response...shall be required. This requirement was not as evidenced by:
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LPA observed that outlet H had been capped off and is no longer usable. Additionally, LPA verified that the fixtures for outlets N and E had been replaced. Director has also advised that outlets N and E have not been used for drinking or preparing food for the three years they
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Lead test results received by Licensing on 01/11/2023, tested on 12/16/2022, showed three outlets in the facility with lead levels exceeding 5 parts per billion (ppb). This poses a potential risk to the health and safety of children in care.
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had been using the rooms, and that they had only used them for hand washing and cleaning toys.

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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:Bettina Engelman
LICENSING EVALUATOR NAME:Salene Mayberry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023


LIC809 (FAS) - (06/04)
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