HICKORY TREE PRESCHOOL

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 09/12/2025, Licensing Program Analyst (LPA) Tyra Chavies conducted an unannounced case management- Lead Testing/ Exceedance visit. LPA met with administrator, Sandy Hallworth, while director, Jennifer walla, taught a class. LPA informed director/administrator about the purpose of the visit and toured the facility. LPA observed 44 children being supervised by 5 staff members.  .  The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE) and conduct an inspection. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all CCCs located in buildings constructed before January 1, 2010, to test their drinking water for lead contamination between January 1, 2020, and January 1, 2023, and then every 5 years after the date of the first test. The CCC must also post the results by January 1, 2023, and every 5 years after the date of the initial test. For a license issued on or after July 1, 2022, the CCC must have its water tested and post the results within 180 days of licensure. Lead testing is not currently a pre-licensing requirement for CCCs. Community Care Licensing was notified that lead water testing conducted at the facility in 2023 exceeded allowable limit for lead. Samples testing over 5.5 ppb/ug L and above is considered an exceedance. NAME OF LICENSING PROGRAM MANAGER: Karren Starks NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/12/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2025 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 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity. PENALTY NOTICE GIVEN The statement concerning civil

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 09/12/2025, Licensing Program Analyst (LPA) Tyra Chavies conducted an unannounced case management- Lead Testing/ Exceedance visit. LPA met with administrator, Sandy Hallworth, while director, Jennifer walla, taught a class. LPA informed director/administrator about the purpose of the visit and toured the facility. LPA observed 44 children being supervised by 5 staff members.  .  The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE) and conduct an inspection. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all CCCs located in buildings constructed before January 1, 2010, to test their drinking water for lead contamination between January 1, 2020, and January 1, 2023, and then every 5 years after the date of the first test. The CCC must also post the results by January 1, 2023, and every 5 years after the date of the initial test. For a license issued on or after July 1, 2022, the CCC must have its water tested and post the results within 180 days of licensure. Lead testing is not currently a pre-licensing requirement for CCCs. Community Care Licensing was notified that lead water testing conducted at the facility in 2023 exceeded allowable limit for lead. Samples testing over 5.5 ppb/ug L and above is considered an exceedance. NAME OF LICENSING PROGRAM MANAGER: Karren Starks NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/12/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2025 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 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity. PENALTY NOTICE GIVEN The statement concerning civil