BLUE LAKE PRESCHOOL

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 06/30/2022 at 9:00 AM, Licensing Program Analyst (LPA) Kiriko Lynch made a collateral inspection and met with Naomi Faulkner and Abraxas Layton. 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 (5.5 ppb) of lead in the water: Blue Lake State Preschool Classroom: Fixture “B” – hallway children’s drinking fountain, 28 ppb The staff have made the fixture inaccessible by: Facility staff have wrapped the fountain in plastic and tape. Facility representative stated the fountain is shut off and not been used since the start of the Covid-19 pandemic. Facility representative stated the fixture was removed and replaced on 03/15/2022, and retested and passed on 04/12/2022. Children in care were receiving drinking water from dispensers and disposable cups filled with water from the facility kitchen sink. 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 the facility representatives Naomi Faulkner and Abraxas Layton. SUPERVISORS NAME: Erin Virrueta LICENSING EVALUATOR NAME: Kiriko Lynch LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022 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 FACILITY NAME: BLUE LAKE PRESCHOOL FACILITY NUMBER: 125400824 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/30/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Request Denied Type B 08/01/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7Buildings and Grounds - The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by: 1 2 3 4 5 6 7The licensee agrees to submit/resubmit an LIC 9275 and LIC 9276 by POC due date. The licensee has made the fixture(s) inaccessible until retested/fixed or replaced, or applicable fixture(s) have been already retested/fixed and replaced or signage posted. 8 9 10 11 12 13 14Based on record review, the facility had fixture(s) that exceeded allowable levels of lead in the water. This is a potential health and safety risk to children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Erin Virrueta LICENSING EVALUATOR NAME:Kiriko Lynch LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 06/30/2022 at 9:00 AM, Licensing Program Analyst (LPA) Kiriko Lynch made a collateral inspection and met with Naomi Faulkner and Abraxas Layton. 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 (5.5 ppb) of lead in the water: Blue Lake State Preschool Classroom: Fixture “B” – hallway children’s drinking fountain, 28 ppb The staff have made the fixture inaccessible by: Facility staff have wrapped the fountain in plastic and tape. Facility representative stated the fountain is shut off and not been used since the start of the Covid-19 pandemic. Facility representative stated the fixture was removed and replaced on 03/15/2022, and retested and passed on 04/12/2022. Children in care were receiving drinking water from dispensers and disposable cups filled with water from the facility kitchen sink. 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 the facility representatives Naomi Faulkner and Abraxas Layton. SUPERVISORS NAME: Erin Virrueta LICENSING EVALUATOR NAME: Kiriko Lynch LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022 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 FACILITY NAME: BLUE LAKE PRESCHOOL FACILITY NUMBER: 125400824 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/30/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Request Denied Type B 08/01/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7Buildings and Grounds - The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by: 1 2 3 4 5 6 7The licensee agrees to submit/resubmit an LIC 9275 and LIC 9276 by POC due date. The licensee has made the fixture(s) inaccessible until retested/fixed or replaced, or applicable fixture(s) have been already retested/fixed and replaced or signage posted. 8 9 10 11 12 13 14Based on record review, the facility had fixture(s) that exceeded allowable levels of lead in the water. This is a potential health and safety risk to children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Erin Virrueta LICENSING EVALUATOR NAME:Kiriko Lynch LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022