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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515405496
Report Date: 02/27/2023
Date Signed: 02/27/2023 09:07:30 AM


Document Has Been Signed on 02/27/2023 09:07 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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



FACILITY NAME:FUSION PRESCHOOL ACADEMY IIFACILITY NUMBER:
515405496
ADMINISTRATOR:EVERETT, KELLIFACILITY TYPE:
850
ADDRESS:1191 LIVE OAK BLVD.TELEPHONE:
(530) 674-7595
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:54CENSUS: 11DATE:
02/27/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Kelli EverettTIME COMPLETED:
09:15 AM
NARRATIVE
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On 2/27/23 at 8:30 AM, Licensing Program Analyst (LPA) J. Helton made a case management inspection and met with Kelli Everett. 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 or greater) of lead in the water:

Fixture E was tested at 150 ppb.

The water sample was noted incorrectly as an outdoor drinking fountain. The fixture is a hose bib and is not used for drinking or preparing food. The corrective action will be to continue to permanently not use this fixture for drinking or preparing foods. The facility has capped the fixture. The facility uses a water deliver service for drinking 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 conducted and report was reviewed with the Director Kelli Everett. .
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Jackie HeltonTELEPHONE: 530-513-0993
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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


Document Has Been Signed on 02/27/2023 09:07 AM - 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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926


FACILITY NAME: FUSION PRESCHOOL ACADEMY II
FACILITY NUMBER: 515405496

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2023
Section Cited

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101700.3(b)(1) California Lead Action Level at Child Care Centers - A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement was not met as evidenced by:
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Facility does not use this fixutre for preparing food or drinking and has capped the fixure off permanently. The fixutre is outside near the playground and is a hose bib, not a drinking fountain
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Based on record review, the facility had 3 faucet(s) with lead test results at or exceeding 5.5 ppb of lead in the water. This is a potential health and safety risk to children in care.
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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: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Jackie HeltonTELEPHONE: 530-513-0993
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
LIC809 (FAS) - (06/04)
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