SMITH LANE EARLY HEAD START

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 06/09/22 at 9:59am, Licensing Program Analyst (LPA) Mendez made a case management inspection and met with Beth Crotty. 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: Faucet "B"- Bathroom sink (adult bathroom), 37ppb Faucet “D” – Children’s restroom sink, 5.6ppb The staff have faucet available for hand washing, and placed a sign above stating that water is not for drinking use. The licensee plans to retest the faucet. Children in care are receiving drinking water from kitchen sink into water pitcher. 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 representative Beth Crotty. SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Bianca Mendez LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022 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: SMITH LANE EARLY HEAD START FACILITY NUMBER: 125407397 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/09/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Request Denied Type B 06/09/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7The 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 an LIC 9275 and LIC 9276 by 7/2/22. The faucets are accesible and made for handwashing with a sign posted. The licensee plans to replace and retest the faucet . Retesting documents will be submitted within 2 weeks of the completed sampling. 8 9 10 11 12 13 14Based on record review, the facility had 2 faucets that exceeded that 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:Megan Aviles LICENSING EVALUATOR NAME:Bianca Mendez LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022

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 06/09/22 at 9:59am, Licensing Program Analyst (LPA) Mendez made a case management inspection and met with Beth Crotty. 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: Faucet "B"- Bathroom sink (adult bathroom), 37ppb Faucet “D” – Children’s restroom sink, 5.6ppb The staff have faucet available for hand washing, and placed a sign above stating that water is not for drinking use. The licensee plans to retest the faucet. Children in care are receiving drinking water from kitchen sink into water pitcher. 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 representative Beth Crotty. SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Bianca Mendez LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022 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: SMITH LANE EARLY HEAD START FACILITY NUMBER: 125407397 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/09/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Request Denied Type B 06/09/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7The 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 an LIC 9275 and LIC 9276 by 7/2/22. The faucets are accesible and made for handwashing with a sign posted. The licensee plans to replace and retest the faucet . Retesting documents will be submitted within 2 weeks of the completed sampling. 8 9 10 11 12 13 14Based on record review, the facility had 2 faucets that exceeded that 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:Megan Aviles LICENSING EVALUATOR NAME:Bianca Mendez LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022

Type B citation - potential risk if not corrected