MARIPOSA HEAD START PRESCHOOL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Stephanie Piring and Office Technician (OT) Yvonne Flores met with Facility Representative, Simona Costa to conduct an unannounced case management inspection regarding lead testing. The purpose of today's inspection was to document a plan of correction following reports of lead exceedance in three of the facility outlets. On 9/24/2024, the facility tested water samples for lead. Lead testing identified three water outlets that has a Lead Exceedance over the amount of 5.5 parts per billion (ppb). The water outlet designated as outlet D has an exceedance of 12 ppb, outlet G has an exceedance of 6.8 ppb, and outlet E has an exceedance of 6.5 ppb. Facility Representative stated water outlets with lead exceedance were covered and placed out of order, the fixtures for outlets D and E were replaced, and they will have the outlet retested after they conclude flushing the outlets for three weeks. Outlet G was taken out and is no longer being used. Facility provides water in a pitcher to children while outside and inside the classroom. A deficiency is cited on the subsequent page of the report and is considered a potential threat to the health and safety of children in care. An exit interview was conducted with the Simona Costa. LPA provided Facility Representative with Appeal Rights and a Notice of Site Visit that must be posted for 30 days. SUPERVISORS NAME: Natalie Dunaway LICENSING EVALUATOR NAME: Stephanie Piring LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024 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: MARIPOSA HEAD START PRESCHOOL FACILITY NUMBER: 340320930 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/14/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/14/2024 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers (b) Testing results with ... (1) A ... values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:1 2 3 4 5 6 7Usage of the faucets were stopped immediately upon receiving the results. Facility Representative stated the faucets has been changed and awaiting retesting. Alternative water in a pitcher is being offered. 8 9 10 11 12 13 14Based on record review, three water outlets tested exceeded the allowed 5.5 ppb, which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14Facility plans to flush water faucets and retest, Facility Representative will send updated passing results to LPA Piring prior to using the fixtures. 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:Natalie Dunaway LICENSING EVALUATOR NAME:Stephanie Piring LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024

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 25Licensing Program Analyst (LPA) Stephanie Piring and Office Technician (OT) Yvonne Flores met with Facility Representative, Simona Costa to conduct an unannounced case management inspection regarding lead testing. The purpose of today's inspection was to document a plan of correction following reports of lead exceedance in three of the facility outlets. On 9/24/2024, the facility tested water samples for lead. Lead testing identified three water outlets that has a Lead Exceedance over the amount of 5.5 parts per billion (ppb). The water outlet designated as outlet D has an exceedance of 12 ppb, outlet G has an exceedance of 6.8 ppb, and outlet E has an exceedance of 6.5 ppb. Facility Representative stated water outlets with lead exceedance were covered and placed out of order, the fixtures for outlets D and E were replaced, and they will have the outlet retested after they conclude flushing the outlets for three weeks. Outlet G was taken out and is no longer being used. Facility provides water in a pitcher to children while outside and inside the classroom. A deficiency is cited on the subsequent page of the report and is considered a potential threat to the health and safety of children in care. An exit interview was conducted with the Simona Costa. LPA provided Facility Representative with Appeal Rights and a Notice of Site Visit that must be posted for 30 days. SUPERVISORS NAME: Natalie Dunaway LICENSING EVALUATOR NAME: Stephanie Piring LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024 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: MARIPOSA HEAD START PRESCHOOL FACILITY NUMBER: 340320930 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/14/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/14/2024 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers (b) Testing results with ... (1) A ... values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:1 2 3 4 5 6 7Usage of the faucets were stopped immediately upon receiving the results. Facility Representative stated the faucets has been changed and awaiting retesting. Alternative water in a pitcher is being offered. 8 9 10 11 12 13 14Based on record review, three water outlets tested exceeded the allowed 5.5 ppb, which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14Facility plans to flush water faucets and retest, Facility Representative will send updated passing results to LPA Piring prior to using the fixtures. 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:Natalie Dunaway LICENSING EVALUATOR NAME:Stephanie Piring LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024