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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525401896
Report Date: 03/09/2023
Date Signed: 03/09/2023 11:35:43 AM


Document Has Been Signed on 03/09/2023 11:35 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:HAPPY TRAILS HEAD STARTFACILITY NUMBER:
525401896
ADMINISTRATOR:DEFONTE, LISAFACILITY TYPE:
850
ADDRESS:645 ANTELOPE BLVD., SUITE 19TELEPHONE:
(530) 528-1963
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:48CENSUS: 27DATE:
03/09/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:02 AM
MET WITH:Samantha HermosilloTIME COMPLETED:
11:40 AM
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On 3/9/23 at 11:02am, Licensing Program Analyst (LPA) Mendez made a case management inspection and met with facility representative Samantha Hermosillo. 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 “I” – exterior water outlet, 48ppb.

The staff have made the faucet inaccessible by placing a bag and posting a sign over the water outlet. Faucet "I" is located in the utdoor play area. Children have access to purified water and have their own individual water bottles refilled.

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 facility representative Samantha Hermosillo.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
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 03/09/2023 11:35 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926


FACILITY NAME: HAPPY TRAILS HEAD START
FACILITY NUMBER: 525401896

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
03/09/2023
Section Cited

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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 representative agrees to submit an LIC 9275 and LIC 9276 by 3/23. The center director posted a sign above the exterior faucet. Retesting documents will be submitted within 2 weeks of the completed sampling or by 3/23/23
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Based on record review, the facility had 1 faucet, faucelt "I" 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: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
LIC809 (FAS) - (06/04)
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