FLORENCE MARKOFER ELEMENTARY SCHOOL

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 03/30/2023, Licensing Program Analysts (LPAs) Erwin Tjhia and Gagandeep Singh met with facilitty representative, Mariana Rojas , for a Case Management inspection. The purpose of the inspection was to follow-up on a lead testing report dated 03/16/2023 which tested the water used for both consumption and hand washing in the facility. LPAs toured the facility and 3 staff members were supervising 20 children. LPA was notified of the lead testing report on 03/16/2022 via email. The report revealed that two water outlets had elevated levels of lead. Facility representative, Mariana Rojas stated that the drinking fountain (Sample A) was inaccessible for use by have it covered. The facility has installed a dispenser as drinking water. Furthermore, the facility representative stated that the water outlet (Sample B) was never been used for cooking or drinking. As a result of the water testing positive for lead, a deficiency was cited on subsequent page 809D. An exit interview was conducted and the report was reviewed with Facility repesentative, Mariana Rojas. Licensee Appeal Rights were provided. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Bettina Engelman LICENSING EVALUATOR NAME: Erwin Tjhia LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023 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 FACILITY NAME: FLORENCE MARKOFER ELEMENTARY SCHOOL FACILITY NUMBER: 340319280 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/30/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 03/30/2023 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7Lead Testing (b)(1) A result which values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by: 1 2 3 4 5 6 7The facility has blocked the faucet with the exceedance and is inaccessible. 8 9 10 11 12 13 14The water report dated 03/30/2023 revealed that the facility had elevated levels of lead in two water fountain. This is a potential health and safety risk to the 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:Bettina Engelman LICENSING EVALUATOR NAME:Erwin Tjhia LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023

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 03/30/2023, Licensing Program Analysts (LPAs) Erwin Tjhia and Gagandeep Singh met with facilitty representative, Mariana Rojas , for a Case Management inspection. The purpose of the inspection was to follow-up on a lead testing report dated 03/16/2023 which tested the water used for both consumption and hand washing in the facility. LPAs toured the facility and 3 staff members were supervising 20 children. LPA was notified of the lead testing report on 03/16/2022 via email. The report revealed that two water outlets had elevated levels of lead. Facility representative, Mariana Rojas stated that the drinking fountain (Sample A) was inaccessible for use by have it covered. The facility has installed a dispenser as drinking water. Furthermore, the facility representative stated that the water outlet (Sample B) was never been used for cooking or drinking. As a result of the water testing positive for lead, a deficiency was cited on subsequent page 809D. An exit interview was conducted and the report was reviewed with Facility repesentative, Mariana Rojas. Licensee Appeal Rights were provided. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Bettina Engelman LICENSING EVALUATOR NAME: Erwin Tjhia LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023 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 FACILITY NAME: FLORENCE MARKOFER ELEMENTARY SCHOOL FACILITY NUMBER: 340319280 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/30/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 03/30/2023 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7Lead Testing (b)(1) A result which values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by: 1 2 3 4 5 6 7The facility has blocked the faucet with the exceedance and is inaccessible. 8 9 10 11 12 13 14The water report dated 03/30/2023 revealed that the facility had elevated levels of lead in two water fountain. This is a potential health and safety risk to the 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:Bettina Engelman LICENSING EVALUATOR NAME:Erwin Tjhia LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023