SIERRA PARK ELEMENTARY SCHOOL CSPP

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25At 12:30 pm Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in water fixtures in the facility. LPA met with Principal Richard Quijano during the visit. Census was taken Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Facility provided facility sketch and required forms LIC 9276, LIC 999 and LIC 9275 to the department. On 02/27/2024, the Department received notification from the State Water Resources Control Board(SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 11/18/2022. Faucets reported with 5.5 ppb or greater lead exceedance levels were as follows: -------------------------------------------------------------------pg. 1 of 2 ------------------------------------------------------------- SUPERVISORS NAME: Brandi VanOosten LICENSING EVALUATOR NAME: Roxana Lopez LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024 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 3 FACILITY NAME: SIERRA PARK ELEMENTARY SCHOOL CSPPFACILITY NUMBER: 197402295 VISIT DATE: 05/02/2024 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 32 Water fountain faucet B located in playground ( 12.400 UG/L) Per Principal Point- of use- filters were installed on faucets mentioned above- were re tested on 1/27/2023 and have been cleared. LPA advised that the department has not received the new results and they should follow up to have the results uploaded. Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information See LIC809D for Type B deficiency cited. A notice of site visit was also provided 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, Teacher Maria Chavez --------------------------------------------- pg 2 of 2 ----------------------------------------------------------- SUPERVISORS NAME: Brandi VanOosten LICENSING EVALUATOR NAME: Roxana Lopez LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024 FACILITY NAME: SIERRA PARK ELEMENTARY SCHOOL CSPP FACILITY NUMBER: 197402295 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 05/02/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 06/03/2024 Section Cited CCR 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1)California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater.., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not me at evidenced by 1 2 3 4 5 6 7Per Principal Point- of- use filters were installed and has been cleared. Principal will follow up for updated results to be uploaded to the waterboard website. 8 9 10 11 12 13 14Based on ispection, the licensee did not comply with the directive above, as the water fouintain faucet B tested with an Action Level Exceedance (ALE) of 12.400 ppb. This poses a potential health and safety risk to children in care8 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:Brandi VanOosten LICENSING EVALUATOR NAME:Roxana Lopez LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25At 12:30 pm Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in water fixtures in the facility. LPA met with Principal Richard Quijano during the visit. Census was taken Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Facility provided facility sketch and required forms LIC 9276, LIC 999 and LIC 9275 to the department. On 02/27/2024, the Department received notification from the State Water Resources Control Board(SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 11/18/2022. Faucets reported with 5.5 ppb or greater lead exceedance levels were as follows: -------------------------------------------------------------------pg. 1 of 2 ------------------------------------------------------------- SUPERVISORS NAME: Brandi VanOosten LICENSING EVALUATOR NAME: Roxana Lopez LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024 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 3 FACILITY NAME: SIERRA PARK ELEMENTARY SCHOOL CSPPFACILITY NUMBER: 197402295 VISIT DATE: 05/02/2024 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 32 Water fountain faucet B located in playground ( 12.400 UG/L) Per Principal Point- of use- filters were installed on faucets mentioned above- were re tested on 1/27/2023 and have been cleared. LPA advised that the department has not received the new results and they should follow up to have the results uploaded. Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information See LIC809D for Type B deficiency cited. A notice of site visit was also provided 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, Teacher Maria Chavez --------------------------------------------- pg 2 of 2 ----------------------------------------------------------- SUPERVISORS NAME: Brandi VanOosten LICENSING EVALUATOR NAME: Roxana Lopez LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024 FACILITY NAME: SIERRA PARK ELEMENTARY SCHOOL CSPP FACILITY NUMBER: 197402295 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 05/02/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 06/03/2024 Section Cited CCR 101700.3(b)(1) 1 2 3 4 5 6 7101700.3(b)(1)California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater.., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not me at evidenced by 1 2 3 4 5 6 7Per Principal Point- of- use filters were installed and has been cleared. Principal will follow up for updated results to be uploaded to the waterboard website. 8 9 10 11 12 13 14Based on ispection, the licensee did not comply with the directive above, as the water fouintain faucet B tested with an Action Level Exceedance (ALE) of 12.400 ppb. This poses a potential health and safety risk to children in care8 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:Brandi VanOosten LICENSING EVALUATOR NAME:Roxana Lopez LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024

Type B citation - potential risk if not corrected