FLETCHER HILLS PRESBYTERIAN CHURCH 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 25On October 25, 2022 at 12:20 p.m., Licensing Program Analyst (LPA) Leilani Curtis made an unannounced Case Management inspection, for reported Lead Exceedance. LPA met with Director, Robin Watson and proceeded to tour the facility. Also present in the facility were 14 daycare children and 6 teachers/staff. Facility was within ratio & capacity. Staff members have the required background clearances. One staff member (S1) has a criminal record clearance but is not associated to the facility. The director states that S1 began working at the facility as a teacher in March 2022. LPA interviewed the director and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and plan of correction via email on 9/6/22. The required signed and dated forms (LIC 9275/9276), were submitted to Community Care Licensing via email on 10/21/22. Faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows: Unit A-drinking fountain located outside next to the Administrative Building. 9.7 ppb Unit D-drinking fountain located outside between rooms #9 and #10. 20.0 ppb All other fountains and water outlets tested within an acceptable level with no lead exceedance. Parents were notified via the parent communication board where the results are posted. The director reported that all faucets in exceedance (Unit A & D) were discontinued from use and bagged on 8/30/22. On 9/8/22 the two water fountains in exceedance were removed and “capped off by the plumber”. At time of inspection LPA observed that the water fountains (Unit A & D) had been removed. The director states that drinking water is available throughout the facility. LPA observed two drinking fountains (Unit B and Unit C) available for use. A filtered water dispenser located in the facility office and a second filtered water dispenser located in the Church office is readily available for use by children and staff. The director states that staff will fill a water pitcher using the filtered water to refill the children's water bottles throughout the day. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 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 4 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER: 370800211 VISIT DATE: 10/25/2022 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 26 27 28 29 30 31 32See LIC809D cited deficiencies. A civil penalty has been assessed. LPA Curtis informed Director Watson that this report dated 10/25/2022 documents one Type A citation. A Type A citation(s) shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Curtis informed Director Watson to provide a copy of this licensing report dated 10/25/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Robin Watson. A notice of site visit was given and must remain posted for 30 days. LPA observed Director Watson post notice of site visit. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOL FACILITY NUMBER: 370800211 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/25/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 10/26/2022 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1) Written Directives: A result with 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 7The director states that all drinking fountains in exceedance were permanently removed on 9/8/22. LPA observed that the two water fountains that were deemed an Action Level Exceedance have been removed. POC has been complet

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 October 25, 2022 at 12:20 p.m., Licensing Program Analyst (LPA) Leilani Curtis made an unannounced Case Management inspection, for reported Lead Exceedance. LPA met with Director, Robin Watson and proceeded to tour the facility. Also present in the facility were 14 daycare children and 6 teachers/staff. Facility was within ratio & capacity. Staff members have the required background clearances. One staff member (S1) has a criminal record clearance but is not associated to the facility. The director states that S1 began working at the facility as a teacher in March 2022. LPA interviewed the director and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and plan of correction via email on 9/6/22. The required signed and dated forms (LIC 9275/9276), were submitted to Community Care Licensing via email on 10/21/22. Faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows: Unit A-drinking fountain located outside next to the Administrative Building. 9.7 ppb Unit D-drinking fountain located outside between rooms #9 and #10. 20.0 ppb All other fountains and water outlets tested within an acceptable level with no lead exceedance. Parents were notified via the parent communication board where the results are posted. The director reported that all faucets in exceedance (Unit A & D) were discontinued from use and bagged on 8/30/22. On 9/8/22 the two water fountains in exceedance were removed and “capped off by the plumber”. At time of inspection LPA observed that the water fountains (Unit A & D) had been removed. The director states that drinking water is available throughout the facility. LPA observed two drinking fountains (Unit B and Unit C) available for use. A filtered water dispenser located in the facility office and a second filtered water dispenser located in the Church office is readily available for use by children and staff. The director states that staff will fill a water pitcher using the filtered water to refill the children's water bottles throughout the day. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 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 4 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER: 370800211 VISIT DATE: 10/25/2022 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 26 27 28 29 30 31 32See LIC809D cited deficiencies. A civil penalty has been assessed. LPA Curtis informed Director Watson that this report dated 10/25/2022 documents one Type A citation. A Type A citation(s) shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Curtis informed Director Watson to provide a copy of this licensing report dated 10/25/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Robin Watson. A notice of site visit was given and must remain posted for 30 days. LPA observed Director Watson post notice of site visit. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOL FACILITY NUMBER: 370800211 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/25/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 10/26/2022 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1) Written Directives: A result with 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 7The director states that all drinking fountains in exceedance were permanently removed on 9/8/22. LPA observed that the two water fountains that were deemed an Action Level Exceedance have been removed. POC has been complet

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 October 25, 2022 at 12:20 p.m., Licensing Program Analyst (LPA) Leilani Curtis made an unannounced Case Management inspection, for reported Lead Exceedance. LPA met with Director, Robin Watson and proceeded to tour the facility. Also present in the facility were 14 daycare children and 6 teachers/staff. Facility was within ratio & capacity. Staff members have the required background clearances. One staff member (S1) has a criminal record clearance but is not associated to the facility. The director states that S1 began working at the facility as a teacher in March 2022. LPA interviewed the director and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and plan of correction via email on 9/6/22. The required signed and dated forms (LIC 9275/9276), were submitted to Community Care Licensing via email on 10/21/22. Faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows: Unit A-drinking fountain located outside next to the Administrative Building. 9.7 ppb Unit D-drinking fountain located outside between rooms #9 and #10. 20.0 ppb All other fountains and water outlets tested within an acceptable level with no lead exceedance. Parents were notified via the parent communication board where the results are posted. The director reported that all faucets in exceedance (Unit A & D) were discontinued from use and bagged on 8/30/22. On 9/8/22 the two water fountains in exceedance were removed and “capped off by the plumber”. At time of inspection LPA observed that the water fountains (Unit A & D) had been removed. The director states that drinking water is available throughout the facility. LPA observed two drinking fountains (Unit B and Unit C) available for use. A filtered water dispenser located in the facility office and a second filtered water dispenser located in the Church office is readily available for use by children and staff. The director states that staff will fill a water pitcher using the filtered water to refill the children's water bottles throughout the day. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 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 4 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER: 370800211 VISIT DATE: 10/25/2022 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 26 27 28 29 30 31 32See LIC809D cited deficiencies. A civil penalty has been assessed. LPA Curtis informed Director Watson that this report dated 10/25/2022 documents one Type A citation. A Type A citation(s) shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Curtis informed Director Watson to provide a copy of this licensing report dated 10/25/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Robin Watson. A notice of site visit was given and must remain posted for 30 days. LPA observed Director Watson post notice of site visit. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOL FACILITY NUMBER: 370800211 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/25/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 10/26/2022 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1) Written Directives: A result with 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 7The director states that all drinking fountains in exceedance were permanently removed on 9/8/22. LPA observed that the two water fountains that were deemed an Action Level Exceedance have been removed. POC has been complet

Type A citation - immediate risk to health, safety, or personal rights

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 October 25, 2022 at 12:20 p.m., Licensing Program Analyst (LPA) Leilani Curtis made an unannounced Case Management inspection, for reported Lead Exceedance. LPA met with Director, Robin Watson and proceeded to tour the facility. Also present in the facility were 14 daycare children and 6 teachers/staff. Facility was within ratio & capacity. Staff members have the required background clearances. One staff member (S1) has a criminal record clearance but is not associated to the facility. The director states that S1 began working at the facility as a teacher in March 2022. LPA interviewed the director and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and plan of correction via email on 9/6/22. The required signed and dated forms (LIC 9275/9276), were submitted to Community Care Licensing via email on 10/21/22. Faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows: Unit A-drinking fountain located outside next to the Administrative Building. 9.7 ppb Unit D-drinking fountain located outside between rooms #9 and #10. 20.0 ppb All other fountains and water outlets tested within an acceptable level with no lead exceedance. Parents were notified via the parent communication board where the results are posted. The director reported that all faucets in exceedance (Unit A & D) were discontinued from use and bagged on 8/30/22. On 9/8/22 the two water fountains in exceedance were removed and “capped off by the plumber”. At time of inspection LPA observed that the water fountains (Unit A & D) had been removed. The director states that drinking water is available throughout the facility. LPA observed two drinking fountains (Unit B and Unit C) available for use. A filtered water dispenser located in the facility office and a second filtered water dispenser located in the Church office is readily available for use by children and staff. The director states that staff will fill a water pitcher using the filtered water to refill the children's water bottles throughout the day. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 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 4 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER: 370800211 VISIT DATE: 10/25/2022 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 26 27 28 29 30 31 32See LIC809D cited deficiencies. A civil penalty has been assessed. LPA Curtis informed Director Watson that this report dated 10/25/2022 documents one Type A citation. A Type A citation(s) shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Curtis informed Director Watson to provide a copy of this licensing report dated 10/25/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Robin Watson. A notice of site visit was given and must remain posted for 30 days. LPA observed Director Watson post notice of site visit. SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Grace Curtis LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022 FACILITY NAME: FLETCHER HILLS PRESBYTERIAN CHURCH PRESCHOOL FACILITY NUMBER: 370800211 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/25/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 10/26/2022 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1) Written Directives: A result with 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 7The director states that all drinking fountains in exceedance were permanently removed on 9/8/22. LPA observed that the two water fountains that were deemed an Action Level Exceedance have been removed. POC has been complet