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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090306370
Report Date: 06/16/2022
Date Signed: 06/16/2022 04:39:05 PM


Document Has Been Signed on 06/16/2022 04:39 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
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: 9DATE:
06/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Caitlin MoranTIME COMPLETED:
04:50 PM
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At 10:20 a.m. on Thursday, June 16th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Program Lead, Caitlin Moran, for the purpose of an unannounced required 1 year inspection. A COVID-19 risk assessment was conducted. Operating hours of the facility are from 7:00 a.m.-5:30 p.m., seven days a week. Facility is currently closed on weekends. A census was conducted during time of arrival. LPA observed 9 children supervised by 1 staff. The Bears classroom is currently not in use.

All individuals subject to criminal background review have obtained criminal record clearance. Program Lead was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. No children in care require medications. Program Lead stated there are no poisons on the premises. Indoor furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste in the have tight fitting lids. The floors appeared clean throughout the facility. The facility provides breakfast, lunch, and afternoon snack. The food preparation space is free of litter and all food was protected against contamination. Drinking water was readily available to children both indoors and outdoors via bottles. Facility uses an online application for sign in and sign out. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. Playground spiral slide is loose at the base. There is currently duct tape to support the loose bolts.

Report continues on 809-C.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 TAHOE
FACILITY NUMBER: 090306370
VISIT DATE: 06/16/2022
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LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by trees.

Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience and AB 1207 Mandated Reporter training certificates.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records.

This facility does not provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

A CARE Tool staff interview was conducted with the Program Lead, Caitlin Moran.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Title 22 Deficiencies are cited on the subsequent pages of this report. Appeal Rights were provided. Program Lead's signature on this report acknowledges receipt of these rights. Exit interview conducted and report was reviewed with Program Lead, Caitlin Moran. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/16/2022 04:39 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 TAHOE
FACILITY NUMBER: 090306370

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(n)
Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above due to the spiral slide being in disrepair, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2022
Plan of Correction
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Proof of documentation for workorder or photo evidence of repair will be supplied to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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