NATI FUENTES CENTRO DE NINOS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Due to required lead testing requirements, Licensing Program Analyst (LPA), Giselle Carbullido conducted a Case Management inspection based on lead testing results received on the facility. LPA Carbullido toured the facility, took census and met with Director, Pamela Robinson to further discuss lead results received and measures taken for remediation of lead exceedances. During the inspection, LPA toured and obtained photos of the following water outlets identified with lead exceedances: Outlets: D, E, H, N, and T including photos of required signage for cessation of use. Facility implemented the following plan of action until formal remediation can be completed on water outlets: D, E, H, N, T: Covered water outlets, posted required signage for non use and completed repairs to all outlets affected. Outlets D and E are drinking fountains at two separate sink in classroom #2 that is not being used; Outlet H is a staff drinking fountain in classroom #3 and children do not use; Outlet N is a staff drinking fountain in classroom #5 and children do not use and outlet T is one of 3 sinks in the kitchen; there are 2 other main sinks for use in the kitchen. Facility has completed repairs and is currently in process for retesting. LPA observed notification of lead results posted at the facility: Front door to reception location. Photos also obtained of additional source for access to water -include children sinks and additional kitchen sinks. Due to facility water outlets testing above approved lead levels, a deficiency has been cited. See LIC809D. Additionally, the following resources were discussed and provided from PIN 21-21-CCP dated July 28, 2021: SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 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 3 FACILITY NAME: NATI FUENTES CENTRO DE NINOSFACILITY NUMBER: 334820958 VISIT DATE: 09/29/2022 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 32101700.6 Grant Funding for Qualifying Child care Centers (a) Senate Bill 862, Chapter 449, Statutes of 2018 allocated $5 Million to the State Water Resources Control Board for testing and remediation of lead in the drinking water of Child Care Centers based on the following criteria: (1) Those that serve children zero to five years of age, with the highest priority for Child Care Centers that provide care for children zero to three years of age. (2) Those that have 50 percent or more of their registered children who receive subsidized care. (3) Those that operate only one facility. (b) To determine a Child Care Center’s eligibility for possible funding the Department will provide access to a link to an online eligibility form located on the Department’s website and on Sacramento State’s Office of Water Programs website. (1) A Child Care Center interested in financial assistance shall complete the eligibility form, which shall include instructions for completing and returning it, prior to receiving any grant funding for which it may qualify. To determine a Child Care Center’s eligibility for possible funding, the provider will need to complete an online eligibility form available at Office of Water Programs’ website An exit interview was conducted, and appeal rights discussed. LPA Carbullido provided Pamela Robinson Director with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years. SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 FACILITY NAME: NATI FUENTES CENTRO DE NINOS FACILITY NUMBER: 334820958 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 09/29/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Under Appeal Type B 10/21/2022 Section Cited CCR 101700.3(b)(1): 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers 101700.3 (b)(1): A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidence by: 1 2 3 4 5 6 7Facility will implement corrective action pursuant to section CCR 101704 for immediate cessation of outlets testing

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Due to required lead testing requirements, Licensing Program Analyst (LPA), Giselle Carbullido conducted a Case Management inspection based on lead testing results received on the facility. LPA Carbullido toured the facility, took census and met with Director, Pamela Robinson to further discuss lead results received and measures taken for remediation of lead exceedances. During the inspection, LPA toured and obtained photos of the following water outlets identified with lead exceedances: Outlets: D, E, H, N, and T including photos of required signage for cessation of use. Facility implemented the following plan of action until formal remediation can be completed on water outlets: D, E, H, N, T: Covered water outlets, posted required signage for non use and completed repairs to all outlets affected. Outlets D and E are drinking fountains at two separate sink in classroom #2 that is not being used; Outlet H is a staff drinking fountain in classroom #3 and children do not use; Outlet N is a staff drinking fountain in classroom #5 and children do not use and outlet T is one of 3 sinks in the kitchen; there are 2 other main sinks for use in the kitchen. Facility has completed repairs and is currently in process for retesting. LPA observed notification of lead results posted at the facility: Front door to reception location. Photos also obtained of additional source for access to water -include children sinks and additional kitchen sinks. Due to facility water outlets testing above approved lead levels, a deficiency has been cited. See LIC809D. Additionally, the following resources were discussed and provided from PIN 21-21-CCP dated July 28, 2021: SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 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 3 FACILITY NAME: NATI FUENTES CENTRO DE NINOSFACILITY NUMBER: 334820958 VISIT DATE: 09/29/2022 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 32101700.6 Grant Funding for Qualifying Child care Centers (a) Senate Bill 862, Chapter 449, Statutes of 2018 allocated $5 Million to the State Water Resources Control Board for testing and remediation of lead in the drinking water of Child Care Centers based on the following criteria: (1) Those that serve children zero to five years of age, with the highest priority for Child Care Centers that provide care for children zero to three years of age. (2) Those that have 50 percent or more of their registered children who receive subsidized care. (3) Those that operate only one facility. (b) To determine a Child Care Center’s eligibility for possible funding the Department will provide access to a link to an online eligibility form located on the Department’s website and on Sacramento State’s Office of Water Programs website. (1) A Child Care Center interested in financial assistance shall complete the eligibility form, which shall include instructions for completing and returning it, prior to receiving any grant funding for which it may qualify. To determine a Child Care Center’s eligibility for possible funding, the provider will need to complete an online eligibility form available at Office of Water Programs’ website An exit interview was conducted, and appeal rights discussed. LPA Carbullido provided Pamela Robinson Director with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years. SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 FACILITY NAME: NATI FUENTES CENTRO DE NINOS FACILITY NUMBER: 334820958 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 09/29/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Under Appeal Type B 10/21/2022 Section Cited CCR 101700.3(b)(1): 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers 101700.3 (b)(1): A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidence by: 1 2 3 4 5 6 7Facility will implement corrective action pursuant to section CCR 101704 for immediate cessation of outlets testing

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Due to required lead testing requirements, Licensing Program Analyst (LPA), Giselle Carbullido conducted a Case Management inspection based on lead testing results received on the facility. LPA Carbullido toured the facility, took census and met with Director, Pamela Robinson to further discuss lead results received and measures taken for remediation of lead exceedances. During the inspection, LPA toured and obtained photos of the following water outlets identified with lead exceedances: Outlets: D, E, H, N, and T including photos of required signage for cessation of use. Facility implemented the following plan of action until formal remediation can be completed on water outlets: D, E, H, N, T: Covered water outlets, posted required signage for non use and completed repairs to all outlets affected. Outlets D and E are drinking fountains at two separate sink in classroom #2 that is not being used; Outlet H is a staff drinking fountain in classroom #3 and children do not use; Outlet N is a staff drinking fountain in classroom #5 and children do not use and outlet T is one of 3 sinks in the kitchen; there are 2 other main sinks for use in the kitchen. Facility has completed repairs and is currently in process for retesting. LPA observed notification of lead results posted at the facility: Front door to reception location. Photos also obtained of additional source for access to water -include children sinks and additional kitchen sinks. Due to facility water outlets testing above approved lead levels, a deficiency has been cited. See LIC809D. Additionally, the following resources were discussed and provided from PIN 21-21-CCP dated July 28, 2021: SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 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 3 FACILITY NAME: NATI FUENTES CENTRO DE NINOSFACILITY NUMBER: 334820958 VISIT DATE: 09/29/2022 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 32101700.6 Grant Funding for Qualifying Child care Centers (a) Senate Bill 862, Chapter 449, Statutes of 2018 allocated $5 Million to the State Water Resources Control Board for testing and remediation of lead in the drinking water of Child Care Centers based on the following criteria: (1) Those that serve children zero to five years of age, with the highest priority for Child Care Centers that provide care for children zero to three years of age. (2) Those that have 50 percent or more of their registered children who receive subsidized care. (3) Those that operate only one facility. (b) To determine a Child Care Center’s eligibility for possible funding the Department will provide access to a link to an online eligibility form located on the Department’s website and on Sacramento State’s Office of Water Programs website. (1) A Child Care Center interested in financial assistance shall complete the eligibility form, which shall include instructions for completing and returning it, prior to receiving any grant funding for which it may qualify. To determine a Child Care Center’s eligibility for possible funding, the provider will need to complete an online eligibility form available at Office of Water Programs’ website An exit interview was conducted, and appeal rights discussed. LPA Carbullido provided Pamela Robinson Director with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years. SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 FACILITY NAME: NATI FUENTES CENTRO DE NINOS FACILITY NUMBER: 334820958 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 09/29/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Under Appeal Type B 10/21/2022 Section Cited CCR 101700.3(b)(1): 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers 101700.3 (b)(1): A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidence by: 1 2 3 4 5 6 7Facility will implement corrective action pursuant to section CCR 101704 for immediate cessation of outlets testing

Type B citation - potential risk if not corrected

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 25Due to required lead testing requirements, Licensing Program Analyst (LPA), Giselle Carbullido conducted a Case Management inspection based on lead testing results received on the facility. LPA Carbullido toured the facility, took census and met with Director, Pamela Robinson to further discuss lead results received and measures taken for remediation of lead exceedances. During the inspection, LPA toured and obtained photos of the following water outlets identified with lead exceedances: Outlets: D, E, H, N, and T including photos of required signage for cessation of use. Facility implemented the following plan of action until formal remediation can be completed on water outlets: D, E, H, N, T: Covered water outlets, posted required signage for non use and completed repairs to all outlets affected. Outlets D and E are drinking fountains at two separate sink in classroom #2 that is not being used; Outlet H is a staff drinking fountain in classroom #3 and children do not use; Outlet N is a staff drinking fountain in classroom #5 and children do not use and outlet T is one of 3 sinks in the kitchen; there are 2 other main sinks for use in the kitchen. Facility has completed repairs and is currently in process for retesting. LPA observed notification of lead results posted at the facility: Front door to reception location. Photos also obtained of additional source for access to water -include children sinks and additional kitchen sinks. Due to facility water outlets testing above approved lead levels, a deficiency has been cited. See LIC809D. Additionally, the following resources were discussed and provided from PIN 21-21-CCP dated July 28, 2021: SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 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 3 FACILITY NAME: NATI FUENTES CENTRO DE NINOSFACILITY NUMBER: 334820958 VISIT DATE: 09/29/2022 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 32101700.6 Grant Funding for Qualifying Child care Centers (a) Senate Bill 862, Chapter 449, Statutes of 2018 allocated $5 Million to the State Water Resources Control Board for testing and remediation of lead in the drinking water of Child Care Centers based on the following criteria: (1) Those that serve children zero to five years of age, with the highest priority for Child Care Centers that provide care for children zero to three years of age. (2) Those that have 50 percent or more of their registered children who receive subsidized care. (3) Those that operate only one facility. (b) To determine a Child Care Center’s eligibility for possible funding the Department will provide access to a link to an online eligibility form located on the Department’s website and on Sacramento State’s Office of Water Programs website. (1) A Child Care Center interested in financial assistance shall complete the eligibility form, which shall include instructions for completing and returning it, prior to receiving any grant funding for which it may qualify. To determine a Child Care Center’s eligibility for possible funding, the provider will need to complete an online eligibility form available at Office of Water Programs’ website An exit interview was conducted, and appeal rights discussed. LPA Carbullido provided Pamela Robinson Director with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years. SUPERVISORS NAME: Gilbert Sena LICENSING EVALUATOR NAME: Giselle Carbullido LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022 FACILITY NAME: NATI FUENTES CENTRO DE NINOS FACILITY NUMBER: 334820958 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 09/29/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Under Appeal Type B 10/21/2022 Section Cited CCR 101700.3(b)(1): 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers 101700.3 (b)(1): A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidence by: 1 2 3 4 5 6 7Facility will implement corrective action pursuant to section CCR 101704 for immediate cessation of outlets testing