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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 325407786
Report Date: 06/07/2022
Date Signed: 06/07/2022 02:28:21 PM


Document Has Been Signed on 06/07/2022 02:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:QUINCY HEAD STARTFACILITY NUMBER:
325407786
ADMINISTRATOR:TOLEN, LEASAFACILITY TYPE:
850
ADDRESS:175 NORTH MILL CREEK ROADTELEPHONE:
(530) 283-0592
CITY:QUINCYSTATE: CAZIP CODE:
95971
CAPACITY:24CENSUS: DATE:
06/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Site Supervisor, Leasa TolenTIME COMPLETED:
02:35 PM
NARRATIVE
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On 6/07/2022 at 1:30pm, Licensing Program Analyst (LPA) Kirk Marks, made a case management inspection and met with Site Supervisor, Leasa Tolen. 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 “A” – office sink faucet, 12ppb
Faucet “B” – children’s classroom sink faucet, 5.8ppb
Faucet “C” – children's classroom sink drinking fountain, 23ppb

Faucet "A" is inaccessible to children as it is in a separate room that is locked from the children entering. Faucet "B" is inaccessible to children drinking and is utilized only for washing of hands. The staff have made faucet "C" inaccessible by bagging it. Signs have also been placed over faucets "A" and "B" stating that the water is not to be used for consumption. The licensee plans to replace and retest the faucet. Children in care are receiving drinking water from bottled water.

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 was conducted and report was reviewed with the Site Supervisor, Leasa Tolen.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk MarksTELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/07/2022 02:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926


FACILITY NAME: QUINCY HEAD START
FACILITY NUMBER: 325407786

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
06/07/2022
Section Cited

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The 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:
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Based on record review, the facility had three faucets that exceeded the allowable levels of lead in the water. This is a potential health and safety risk to children in care.
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The third was made temporarily inaccessible by bagging the faucet. The licensee plans to replace and retest the faucet. Retesting documents will be submitted within 2 weeks of the completed sampling.

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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 AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk MarksTELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2022
LIC809 (FAS) - (06/04)
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