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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585407404
Report Date: 04/10/2024
Date Signed: 04/10/2024 03:38:43 PM

Document Has Been Signed on 04/10/2024 03:38 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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:FUSION EARLY LEARNING PRE-SCHOOLFACILITY NUMBER:
585407404
ADMINISTRATOR/
DIRECTOR:		CHARLSON, CLINTFACILITY TYPE:
850
ADDRESS:1280 ZANES DRIVETELEPHONE:
(916) 296-8011
CITY:PLUMAS LAKESTATE: CAZIP CODE:
95961
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 45DATE:
04/10/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:56 PM
MET WITH:Clint CharlsonTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
NARRATIVE
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On 4/10/24 @ 2:56 PM an unannounced case management visit was conducted by Licensing Program Analyst (LPA) Elizabeth Friese due to the facility having not met the lead testing deadline of 1/01/2023. 5 teachers were supervising 45 children and operating within the licensed capacity and ratio requirements.

The following deficiency was cited: A review of lead test results indicate the test was completed on 4/6/2024 which is after the required date of 1/1/2023. (See LIC 809D)

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.



Exit interview conducted and report was reviewed with the licensee.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Elizabeth Friese
LICENSING EVALUATOR SIGNATURE: DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2024
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 04/10/2024 03:38 PM - It Cannot Be Edited


Created By: Elizabeth Friese On 04/10/2024 at 03:20 PM
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: FUSION EARLY LEARNING PRE-SCHOOL
FACILITY NUMBER: 585407404

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/10/2024
Section Cited
CCR
1596.76

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(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... no later than January 1, 2023, and every five years after the date of the initial test.
This requirement is not met as evidenced by:
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Licensee Clint Charlson agrees to provide lead test results, LIC9275, LIC 9276 and LIC 999 as required. Licensee agrees to ensure results are uploaded on the State website. Proof of correction shall be submitted to CCLD on or before 5/10/2024.
elizabeth.friese@dss.ca.gov
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Based on record review and observation, the licensee did not comply with the section cited above in one out of one lead test results which poses a potential health, safety or personal rights risk to persons 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:Elizabeth Friese
LICENSING EVALUATOR SIGNATURE:
DATE: 04/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2024


LIC809 (FAS) - (06/04)
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