CHRYSALIS CHILD CARE CENTER

Type B citation - potential risk if not corrected

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 4/25/24 at 12:15pm, Licensing Program Analyst (LPA) N. Cunningham made a case management inspection and met with licensee Jenny Dooley. 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 facility tested the water after 1/1/23. 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 director. SUPERVISORS NAME: Erin Virrueta LICENSING EVALUATOR NAME: Nicolette Cunningham LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024 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 FACILITY NAME: CHRYSALIS CHILD CARE CENTER FACILITY NUMBER: 475407772 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/26/2024 Section Cited HSC 1596.76(1) 1 2 3 4 5 6 7(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.1 2 3 4 5 6 7Community Care Licensing received proof of testing. Citation cleared. 8 9 10 11 12 13 14Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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: 04/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024

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 4/25/24 at 12:15pm, Licensing Program Analyst (LPA) N. Cunningham made a case management inspection and met with licensee Jenny Dooley. 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 facility tested the water after 1/1/23. 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 director. SUPERVISORS NAME: Erin Virrueta LICENSING EVALUATOR NAME: Nicolette Cunningham LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024 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 FACILITY NAME: CHRYSALIS CHILD CARE CENTER FACILITY NUMBER: 475407772 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/26/2024 Section Cited HSC 1596.76(1) 1 2 3 4 5 6 7(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.1 2 3 4 5 6 7Community Care Licensing received proof of testing. Citation cleared. 8 9 10 11 12 13 14Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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: 04/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024

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 4/25/24 at 12:15pm, Licensing Program Analyst (LPA) N. Cunningham made a case management inspection and met with licensee Jenny Dooley. 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 facility tested the water after 1/1/23. 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 director. SUPERVISORS NAME: Erin Virrueta LICENSING EVALUATOR NAME: Nicolette Cunningham LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024 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 FACILITY NAME: CHRYSALIS CHILD CARE CENTER FACILITY NUMBER: 475407772 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/26/2024 Section Cited HSC 1596.76(1) 1 2 3 4 5 6 7(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.1 2 3 4 5 6 7Community Care Licensing received proof of testing. Citation cleared. 8 9 10 11 12 13 14Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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: 04/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024

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 4/25/24 at 12:15pm, Licensing Program Analyst (LPA) N. Cunningham made a case management inspection and met with licensee Jenny Dooley. 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 facility tested the water after 1/1/23. 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 director. SUPERVISORS NAME: Erin Virrueta LICENSING EVALUATOR NAME: Nicolette Cunningham LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024 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 FACILITY NAME: CHRYSALIS CHILD CARE CENTER FACILITY NUMBER: 475407772 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 04/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/26/2024 Section Cited HSC 1596.76(1) 1 2 3 4 5 6 7(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.1 2 3 4 5 6 7Community Care Licensing received proof of testing. Citation cleared. 8 9 10 11 12 13 14Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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: 04/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024