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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343605634
Report Date: 06/07/2022
Date Signed: 06/07/2022 03:34:37 PM

Document Has Been Signed on 06/07/2022 03:34 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 - STONE LAKEFACILITY NUMBER:
343605634
ADMINISTRATOR:SIGALA, CINDYFACILITY TYPE:
840
ADDRESS:9673 LAKEPOINTTELEPHONE:
(916) 683-9699
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 110TOTAL ENROLLED CHILDREN: 110CENSUS: 6DATE:
06/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Cindy SigalaTIME COMPLETED:
04:00 PM
NARRATIVE
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On 06/07/2022, Licensing Program Analyst (LPA) Katy Maestas met with Center Manager Cindy Sigala for a Case Management inspection. Upon arrival, LPA disclosed the purpose of the visit and was granted entrance by Sigala. The purpose of the inspection was to follow-up on a lead testing report dated 04/25/2022 which tested the water used for both consumption and hand washing in the facility. LPA toured the facility and 6 staff members were supervising 6 children. LPA verified that all adults were cleared and associated to the license through accessing Guardian.

LPA was notified of the lead testing report on 04/26/2022 via email. The report revealed that two water outlets had elevated levels of lead. Center Manager Sigala reported that the fountains had been marked as "closed" and were currently inaccessible for use. Sigala also stated the fountains had not been used since March 2020 when they were tapped off to be inaccessible for use due to COVID-19.

During today's inspection, LPA verified that the affected water outlets are not in use. The fountains were replaced on 04/26/2022. Sigala stated that she is finished flushing the water outlets as they were re-tested for lead on 06/01/2022 and 06/02/2022. Sigala is waiting for the completed report from Adviro. Sigara understands that the report should be sent to LPA via email by 06/21/2022.

As a result of the water testing positive for lead, a deficiency was cited on a subsequent page, 809D. An exit interview was conducted and the report was reviewed with Center Manager, Cindy Sigala. Licensee Appeal Rights were provided. A Notice of Site 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.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2022
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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Document Has Been Signed on 06/07/2022 03:34 PM - It Cannot Be Edited


Created By: Nola Maestas On 06/07/2022 at 03:10 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: CATALYST KIDS - STONE LAKE
FACILITY NUMBER: 343605634

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2022
Section Cited
CCR
101238(a)

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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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During today's visit LPA observed that the affected water outlets are not in use. Center Manager stated that once she was informed, she took immediate action. Maintanence has repaired the faucet and re-testing took place on 06/01/2022 and 06/02/2022.
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The water report dated 04/25/2022 revealed that the facility had elevated levels of lead in two water fountains. This is a violation, that if not corrected, can pose a health and safety risk to the children in care.
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LPA will follow-up with the facility once re-testing results have been reported.

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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 Smith
LICENSING EVALUATOR NAME:Nola Maestas
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2022


LIC809 (FAS) - (06/04)
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