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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090306370
Report Date: 08/08/2022
Date Signed: 08/09/2022 10:21:11 AM


Document Has Been Signed on 08/09/2022 10:21 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:CATALYST KIDS - SOUTH LAKE TAHOEFACILITY NUMBER:
090306370
ADMINISTRATOR:HUGHES,ALEXISFACILITY TYPE:
850
ADDRESS:3441 SPRUCE AVENUETELEPHONE:
(530) 541-5887
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY:48CENSUS: 6DATE:
08/08/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Catlyn MoranTIME COMPLETED:
10:45 AM
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Licensing Program Analyst Arianna Manabat met with Site Supervisor Caitlin Moran for an unannounced Case Management Inspection. LPA observed 6 children in care with two staff and the site supervisor. The purpose of today’s inspection was to follow up regarding water sampling that indicated Action Level Exceedance (ALE) for a drinking fountain that was tested for lead levels on 06/16/2022. On 06/23/2022, the facility was notified that water levels were in exceedance of 5 parts per billion in the drinking fountain that was tested.

The water faucet is upstairs in the facility, has never been used for the purpose of childcare, and has not been operable for a couple of years. LPA Manabat was informed that the upstairs area was previously used for the owner who lived in that area. The area is inaccessible to children and is utilized as a storage area. The faucet is not used for drinking, cooking, washing hands, or any daily activities and is inoperable.

The facility uses another faucet that was tested as safe for use for drinking water. No deficiencies are cited at this time. LPA reviewed this report with the Site Supervisor and conducted an exit interview. A Notice of Site Visit was provided and should remain posted for 30 days.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna ManabatTELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2022
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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