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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455408166
Report Date: 01/25/2023
Date Signed: 01/25/2023 09:34:00 AM

Document Has Been Signed on 01/25/2023 09:34 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:SCOE - SYCAMORE STATE PRESCHOOLFACILITY NUMBER:
455408166
ADMINISTRATOR:GROVES, BRANDYFACILITY TYPE:
850
ADDRESS:1926 SYCAMORE DRTELEPHONE:
(530) 229-8518
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY: 24TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
01/25/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Sandi Downing, Site SupervisorTIME COMPLETED:
09:50 AM
NARRATIVE
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On 1/25/23 at 8:50am, Licensing Program Analyst (LPA) N. Cunningham made a case management inspection and met with S. Downing. 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:

Faucet “D” – drinking fountain, 5.7ppb

The facility permanently removed the faucet. Children in care are receiving drinking water from another drinking fountain.

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 site supervisor, S. Downing.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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 01/25/2023 09:34 AM - It Cannot Be Edited


Created By: Nicolette Cunningham On 01/25/2023 at 09:04 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: SCOE - SYCAMORE STATE PRESCHOOL
FACILITY NUMBER: 455408166

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
01/26/2023
Section Cited
CCR
101700.3(b)1

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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:
Based on record review, the facility had one 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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The facility permanently removed the drinking fountain.

Deficiency corrected on this date.

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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:Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023


LIC809 (FAS) - (06/04)
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