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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343604806
Report Date: 05/20/2022
Date Signed: 05/20/2022 01:39:47 PM


Document Has Been Signed on 05/20/2022 01:39 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 - JOSEPH SIMSFACILITY NUMBER:
343604806
ADMINISTRATOR:CASSANDRA BRUMFIELDFACILITY TYPE:
840
ADDRESS:3033 BUCKMINSTER DRIVETELEPHONE:
(916) 905-0561
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:140CENSUS: 6DATE:
05/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Cassandra BrumfieldTIME COMPLETED:
02:00 PM
NARRATIVE
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On 05/20/2022, Licensing Program Analyst (LPA) Katy Maestas met with Site Supervisor, Cassandra Brumfield, for a Case Management inspection. The purpose of the inspection was to follow-up on a lead testing report dated 04/26/2022 which tested the water used for both consumption and hand washing in the facility. LPA toured the facility and 2 staff members were supervising 6 children. All adults were clear and associated with the license in Guardian.

LPA was notified of the lead testing report on 04/26/2022 via email. The report revealed that 5 water outlets (3 drinking fountains and 2 faucets) had elevated levels of lead. Site Supervisor Brumfield reported that the water outlets had been marked as "closed" and were inaccessible for use. Purified water is being purchased and served from a water dispenser for the purpose of consumption. In addition, Brumfield stated that facility was not using the drinking fountains due to COVID-19.

During today's inspection, LPA verified that the affected water outlets are not in use. The water fountains and faucets were replaced on 04/28/2022. Brumfield stated that she is currently flushing the faucets 4 times per day for 4 weeks. At which point, the water outlets will be re-tested for lead and reported to LPA.

As a result of the water testing positive for lead, a deficiency was cited on subsequent page 809D. An exit interview was conducted and the report was reviewed with Site Supervisor, Cassandra Brumfield. Licensee Appeal Rights were provided. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022
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


Document Has Been Signed on 05/20/2022 01:39 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 - JOSEPH SIMS
FACILITY NUMBER: 343604806

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
06/03/2022
Section Cited

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101238 Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by:
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The water report dated 04/26/2022 revealed that the facility had elevated levels of lead in 5 water outlets. This is a violation that if not corrected can pose a health and safety risk to the children in care. LPA will follow-up with the facility once re-testing results have been reported.
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The water report dated 04/26/2022 revealed that the facility had elevated levels of lead in five water outlets. This is a violation that if not corrected can pose a health and safety risk to the children 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: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022
LIC809 (FAS) - (06/04)
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