090306370-6-16-2022-03-CC-SDLA-CG4RS2-20220707131602

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 090306370
Report Date: 06/16/2022
Date Signed: 06/16/2022 04:44:55 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/03/2022 and conducted by Evaluator Karyn Guerra

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220603163119

FACILITY NAME:	CATALYST KIDS - SOUTH LAKE TAHOE		FACILITY NUMBER:	090306370
ADMINISTRATOR:	HUGHES,ALEXIS		FACILITY TYPE:	850
ADDRESS:	3441 SPRUCE AVENUE		TELEPHONE:	(530) 541-5887
CITY:	SOUTH LAKE TAHOE	STATE: CA	ZIP CODE:	96150
CAPACITY:	48	CENSUS: 9	DATE:	06/16/2022
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Caitlin Moran		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Unqualified staff supervising children in care.

INVESTIGATION FINDINGS:

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At 10:20 a.m., Licensing Program Analyst (LPA) Karyn Guerra met with Program Lead, Caitlin Moran, for the purpose of an unannounced complaint inspection. It was alleged that unqualified staff are supervising children in care. Throughout the course of the investigation, LPA conducted interviews, made observations, conducted a file review, and received documentation. LPA came to learn that there are times when aides at the facility (S1, S2) have been left alone to supervise children for staff breaks. Breaks were stated to have occurred outside of nap time. It was also learned that Aides have been left alone to supervise napping children without a fully qualified teacher on the premises. LPA also came to learn of a staffing issue that occurred on June 3rd, 2022, in which only the Program Lead and an aide at the facility (S1) were on the staffing schedule for the day after support staffing fell through. It was stated that the aide was left alone to supervise children while the Program Lead took their required break. The facility later closed for a

report continued on 9099-C.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (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.

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20220603163119

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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

NARRATIVE

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period due to insufficient staffing. The preponderance of evidence standard has been met, and the allegation is substantiated.

Title 22 deficiencies are cited on the subsequent pages of this report. Program Lead acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Program Lead's signature on this report acknowledges receipt of these rights. This report was reviewed with the Program Lead, Caitlin Moran. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (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

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 03-CC-20220603163119

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/17/2022 Section Cited CCR 101216(b)	1 2 3 4 5 6 7	1012161 Teacher Qualifications and Duties. (b) Prior to employment a teacher shall meet the specified requirements...This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	A follow up inspection will be conducted to clear citation.
	8 9 10 11 12 13 14	Based on interviews and record review, Staff 1 (S1) was left alone with children in care. Staff 1 is not a qualified teacher as they do not have ECE units. This poses an immediate health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (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

LIC9099 (FAS) - (06/04)

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