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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090313184
Report Date: 07/01/2024
Date Signed: 07/01/2024 11:43:00 AM

Document Has Been Signed on 07/01/2024 11:43 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - SOUTH LAKE TAHOEFACILITY NUMBER:
090313184
ADMINISTRATOR/
DIRECTOR:		KAUR, BALJITFACILITY TYPE:
840
ADDRESS:3441 SPRUCE AVENUETELEPHONE:
(530) 541-5887
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY: 47TOTAL ENROLLED CHILDREN: 47CENSUS: 24DATE:
07/01/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Baljit KaurTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On July 1st, 2024, Licensing Program Analyst (LPA) Soleil Marx met with Director, Baljit Kaur, for an unannounced Case Management Inspection to address a lead exceedance within the facility. The purpose of today’s inspection was explained.

On 11/30/2022, the facility tested their water samples for lead. The Lead Testing results identified one water outlet that has a Lead Exceedance over the amount of 5.5ppb. The water outlet sampled is marked A, which has an exceedance of 8.8ppb.

The water outlet marked A is located in the off-limits upstairs area of the facility. The upstairs area of the facility is inaccessible to children and is utilized only as a storage area. The water outlet is not used for drinking, cooking, washing hands, or any daily activities and is in inoperable state. The facility uses alternate water sources that tested safe for drinking water.



No deficiencies are cited at this time. Exit interview conducted and report reviewed with Director, Baljit Kaur and conducted an exit interview. A Notice of Site Visit was provided and should remain posted for 30 days
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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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