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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 123005885
Report Date: 05/20/2022
Date Signed: 05/20/2022 12:29:23 PM

Document Has Been Signed on 05/20/2022 12:29 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:CHILDREN OF THE REDWOODS INFANT TODDLER CENTERFACILITY NUMBER:
123005885
ADMINISTRATOR:WYRICK, LAURAFACILITY TYPE:
830
ADDRESS:3609 SPEAR AVENUETELEPHONE:
(707) 822-8020
CITY:ARCATASTATE: CAZIP CODE:
95521
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 2DATE:
05/20/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Laura WyrickTIME COMPLETED:
12:45 PM
NARRATIVE
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On 05/20/2022 at 8:45 AM, Licensing Program Analyst (LPA) Kiriko Lynch made a case management inspection and met with Laura Wyrick. 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 “C” – staff restroom 1, 16 ppb

The staff have made the faucet inaccessible by: the location the sink is in the staff restroom and children will not be using the restroom unless child is isolating due to illness under supervision of a staff member. The licensee plans to use a permanent placard identifying the outlet as a hand-washing only, non-potable use only/not for human consumption. Children in care are receiving drinking water from filtered pitchers and disposable cups, filled with water from the facility kitchen sink. LPA noted this faucet was tested due to an optional testing by the facility, and not mandated by the regulations.

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 Laura Wyrick.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2022
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 05/20/2022 12:29 PM - It Cannot Be Edited


Created By: Kiriko Lynch On 05/20/2022 at 10:53 AM
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: CHILDREN OF THE REDWOODS INFANT TODDLER CENTER
FACILITY NUMBER: 123005885

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
06/20/2022
Section Cited
CCR
101238(a)

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101238(a) 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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The licensee agrees to submit an LIC 9275 and LIC 9276 by 06/20/2022. The licensee has made the faucet inaccessible by: it is located in the staff restroom and not accessible to children except when ill and isolating with direct staff supervision.
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Based on record review, the facility had one faucet that exceeded that allowable levels of lead in the water. This is a potential health and safety risk to children in care.
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The licensee plans to use a permanent placard to label the sink for hand-washing only, non-potable use only, and will provide training for all current and future staff on sink use.

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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 Virrueta
LICENSING EVALUATOR NAME:Kiriko Lynch
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022


LIC809 (FAS) - (06/04)
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