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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 061308899
Report Date: 06/10/2024
Date Signed: 06/10/2024 12:23:45 PM

Document Has Been Signed on 06/10/2024 12:23 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:OUR LADY OF LOURDES PRESCHOOLFACILITY NUMBER:
061308899
ADMINISTRATOR/
DIRECTOR:		HODGES, SUSANFACILITY TYPE:
850
ADDRESS:741 WARE AVENUETELEPHONE:
(530) 458-8208
CITY:COLUSASTATE: CAZIP CODE:
95932
CAPACITY: 21TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/10/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Ramon Silva, PrincipalTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 6/10/2024 at 11:30am, Licensing Program Analyst (LPA) Laura Chavez conducted a case management inspection and met with Principal Ramon Silva. 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 faucet tested above the allowable level (5 ppb) of lead in the water:

Faucet “B” – drinking fountain located on wall, 21.400ppb

Preschool is not in session currently. The preschool will commence on August 15, 2024. The principal plans to permanently cap the faucet. Children in care will receive drinking water from Faucet A located inside the classroom. All Parents and Guardians of children in care will be notified of the steps taken to correct the deficiency.

The following deficiency is being cited: 101700.3(b)(2), (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 Principal Ramon Silva.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2024
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 06/10/2024 12:23 PM - It Cannot Be Edited


Created By: Laura Chavez On 06/10/2024 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: OUR LADY OF LOURDES PRESCHOOL
FACILITY NUMBER: 061308899

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2024
Section Cited
CCR
101700.3(b)(2)

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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. This requirement was not met as evidenced by:
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The Principal agrees to permanently cap the faucet. Photos of the capped faucet will be sent to CCLD on or by 7/10/2024. Parents/Guardians of all children in care will be notified of the steps taken to correct the deficiency by August 15, 2024.
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Based on record review, the facility had 1 faucet 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 Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2024


LIC809 (FAS) - (06/04)
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