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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585402247
Report Date: 08/28/2023
Date Signed: 09/22/2023 03:58:32 PM


Document Has Been Signed on 09/22/2023 03:58 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 09/22/2023 03:57 PM

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

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This report is amended to reflect the correct exceedances.

On 8/28/23 at 11:00am, Licensing Program Analyst (LPA) E. Laird made a case management inspection and met with Nichole Steenberg. 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 ppb) of lead in the water:

Faucet "D"-Classroom #33 Sink, 7.12ppb

The licensee has made the faucet(s) inaccessible by . The licensee replaced faucets over the summer break and retested all faucets on 8/23/23. Children in care are receiving drinking water from water bottles.

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, Nichole Steenberg.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Erica LairdTELEPHONE: 530-895-5045
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2023
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 08/28/2023 11:58 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: LONE TREE STATE PRESCHOOL
FACILITY NUMBER: 585402247

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/28/2023
Section Cited
HSC
101700.3(b)(2)

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101700.3(b)(2) Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.
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The licensee has made the faucets temporarily inaccessible by posting signage. The licensee has replaced and retested the faucet and is awaiting results. Retesting documents will be submitted within 2 weeks of the completed sampling.
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This requirement was not met as evidenced by:
Based on record review, the facility had faucet(s) with lead test results exceeding 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: Erica LairdTELEPHONE: 530-895-5045
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2023
LIC809 (FAS) - (06/04)
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