SETA - CROSSROADS 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 25Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative, Anthy Thao, for a case management inspection. The purpose of the inspection was to discuss the lead in facility water report. During today's inspection, LPA discuss the report with the facility representative. LPA explained to the facility representative that all faucets that are used for drinking or cooking, must have less than 5.5 PPB lead. The facility had water tested on July 27, 2022 and it was found that in one of the tested faucet had 7.2 PPB lead in the water. The facility representative stated that the facility has not been using the faucet since the day results came in. LPA observed the faucet in the classroom, which exceeded the requirement. LPA asked the facility representative to keep the faucet inaccessible. See next page for deficiency cited today. Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days. SUPERVISORS NAME: Natalie Dunaway LICENSING EVALUATOR NAME: Gagandeep Singh LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2022 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: SETA - CROSSROADS HEAD START FACILITY NUMBER: 343606272 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/10/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 10/21/2022 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers. b) Testing results with fractional ppb readings of 0.5 or greater shall be rounded up to the nearest whole number, 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 was not 1 2 3 4 5 6 7The facility representative stated that facility will make sure that the faucet is inaccessible for the children to use. 8 9 10 11 12 13 14met as evidenced by based on results of a test conduct on a faucet on July 27, 2022 indicated 7.2 ppb in the faucet water, which exceed 5.5 ppb requirement. This is a potential risk to the health and safety of children in care if not corrected.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:Natalie Dunaway LICENSING EVALUATOR NAME:Gagandeep Singh LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2022

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative, Anthy Thao, for a case management inspection. The purpose of the inspection was to discuss the lead in facility water report. During today's inspection, LPA discuss the report with the facility representative. LPA explained to the facility representative that all faucets that are used for drinking or cooking, must have less than 5.5 PPB lead. The facility had water tested on July 27, 2022 and it was found that in one of the tested faucet had 7.2 PPB lead in the water. The facility representative stated that the facility has not been using the faucet since the day results came in. LPA observed the faucet in the classroom, which exceeded the requirement. LPA asked the facility representative to keep the faucet inaccessible. See next page for deficiency cited today. Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days. SUPERVISORS NAME: Natalie Dunaway LICENSING EVALUATOR NAME: Gagandeep Singh LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2022 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: SETA - CROSSROADS HEAD START FACILITY NUMBER: 343606272 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/10/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 10/21/2022 Section Cited 101700.3(b)(1) 1 2 3 4 5 6 7California Lead Action Level at Child Care Centers. b) Testing results with fractional ppb readings of 0.5 or greater shall be rounded up to the nearest whole number, 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 was not 1 2 3 4 5 6 7The facility representative stated that facility will make sure that the faucet is inaccessible for the children to use. 8 9 10 11 12 13 14met as evidenced by based on results of a test conduct on a faucet on July 27, 2022 indicated 7.2 ppb in the faucet water, which exceed 5.5 ppb requirement. This is a potential risk to the health and safety of children in care if not corrected.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:Natalie Dunaway LICENSING EVALUATOR NAME:Gagandeep Singh LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2022

Type B citation - potential risk if not corrected