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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 511306470
Report Date: 12/02/2022
Date Signed: 12/02/2022 10:49:19 AM

Document Has Been Signed on 12/02/2022 10:49 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:MIGRANT CHILD CARE CENTER/STATE PROGRAMSFACILITY NUMBER:
511306470
ADMINISTRATOR:MALDONADO, INEZFACILITY TYPE:
850
ADDRESS:445 BERNARD DRIVE, BUILDING #2TELEPHONE:
(530) 822-5235
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY: 57TOTAL ENROLLED CHILDREN: 57CENSUS: 12DATE:
12/02/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Inez MaldonadoTIME COMPLETED:
11:00 AM
NARRATIVE
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On 12/2/2022 at 10:45 AM, Licensing Program Analyst (LPA) J. Helton made a case management inspection and met with Inez Maldonado. 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:

Drinking Faucet G tested at 6.427

Drinking Faucet H tested at 29.380

Drinking Faucet J tested at 10.670

All faucets were covered until corrective actions were completed. Children and staff were provided bottled water. YCUSD maintenance and Director had the faucets retested and results were within normal range..


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 Site Supervisor Inez Maldonado.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
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 12/02/2022 10:49 AM - It Cannot Be Edited


Created By: Jackie Helton On 12/02/2022 at 10:30 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: MIGRANT CHILD CARE CENTER/STATE PROGRAMS
FACILITY NUMBER: 511306470

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2022
Section Cited
HSC
101700.3(b)(1)

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101700.3(b)(1) 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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The licensee has made the faucets temporarily inaccessible by blocking/covering. The licensee retested the faucets. Retesting documents have been submitted and results are within normal limits
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Based on record review, the facility had 3 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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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:Jackie Helton
LICENSING EVALUATOR SIGNATURE:
DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2022


LIC809 (FAS) - (06/04)
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