HEAD START - FULLER PARK CENTER

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 7/13/2022 at 08:55am, Licensing Program Analyst (LPA), Kevin O'Connell made a case management inspection and met with Facilities Supervisor, Miguel Campos. This was an announced inspection as the facility has been closed since May 30th for summer break and will reopen in mid-August as this facility follows the local school calendar. 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 outlets/faucets tested above the allowable level (5 ppb) of lead in the water: Faucet "C" - "kitchen sink faucet", 5.600 ppb The staff have made the kitchen sink faucet inaccessible by: the facility was closed to children after the test results were received. The faucet was replaced on 6/20/22 per the recommendations of the water test company. They were scheduled to take a re-sample on 7/23/22. The facility will update CCL when they receive the results. 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 Facilities Supervisor, Miguel Campos. SUPERVISORS NAME: Leslie Lepori LICENSING EVALUATOR NAME: Kevin O'Connell LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022 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: HEAD START - FULLER PARK CENTER FACILITY NUMBER: 280102626 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 07/13/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 08/06/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7Buildings and Grounds 101238(a) The child care center shall be clean, safe, sanitary and in good repair at all times to 1 2 3 4 5 6 7The Licensee posted a sign on the kitchen sink faucet. The Licensee replaced the faucet and was scheduled to be retested on 7/23/22. 8 9 10 11 12 13 14ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by: Based on record review, the facility had 1 faucet 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 14Retesting documents will be submitted within 2 weeks of the completed test sampling of 7/23/22 which will be 8/6/22. kevin.oconnell@dss.ca.gov 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:Leslie Lepori LICENSING EVALUATOR NAME:Kevin O'Connell LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022

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 7/13/2022 at 08:55am, Licensing Program Analyst (LPA), Kevin O'Connell made a case management inspection and met with Facilities Supervisor, Miguel Campos. This was an announced inspection as the facility has been closed since May 30th for summer break and will reopen in mid-August as this facility follows the local school calendar. 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 outlets/faucets tested above the allowable level (5 ppb) of lead in the water: Faucet "C" - "kitchen sink faucet", 5.600 ppb The staff have made the kitchen sink faucet inaccessible by: the facility was closed to children after the test results were received. The faucet was replaced on 6/20/22 per the recommendations of the water test company. They were scheduled to take a re-sample on 7/23/22. The facility will update CCL when they receive the results. 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 Facilities Supervisor, Miguel Campos. SUPERVISORS NAME: Leslie Lepori LICENSING EVALUATOR NAME: Kevin O'Connell LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022 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: HEAD START - FULLER PARK CENTER FACILITY NUMBER: 280102626 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 07/13/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 08/06/2022 Section Cited CCR 101238(a) 1 2 3 4 5 6 7Buildings and Grounds 101238(a) The child care center shall be clean, safe, sanitary and in good repair at all times to 1 2 3 4 5 6 7The Licensee posted a sign on the kitchen sink faucet. The Licensee replaced the faucet and was scheduled to be retested on 7/23/22. 8 9 10 11 12 13 14ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by: Based on record review, the facility had 1 faucet 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 14Retesting documents will be submitted within 2 weeks of the completed test sampling of 7/23/22 which will be 8/6/22. kevin.oconnell@dss.ca.gov 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:Leslie Lepori LICENSING EVALUATOR NAME:Kevin O'Connell LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022

Type B citation - potential risk if not corrected