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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617318
Report Date: 05/20/2022
Date Signed: 05/20/2022 12:10:34 PM

Document Has Been Signed on 05/20/2022 12:10 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 - ELLIOTT RANCHFACILITY NUMBER:
343617318
ADMINISTRATOR:RAMM, KIMBERLYFACILITY TYPE:
850
ADDRESS:10000 E. TARON DRIVETELEPHONE:
(916) 714-2313
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
05/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Lashonda BollingTIME COMPLETED:
12:30 PM
NARRATIVE
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On 05/20/2022, Licensing Program Analyst (LPA) Katy Maestas met with Center Manager, Lashonda Bolling, for a Case Management inspection. 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 5 staff members were supervising 10 children. All adults were cleared and associated to the license in Guardian.

LPA was notified of the lead testing report on 04/25/2022 via email. The report revealed that one water outlet had elevated levels of lead. Center Manager Bolling reported that the faucet had been marked as "closed" and was inaccessible for use.

During today's inspection, LPA verified that the affected water outlet is not in use. The faucet was replaced on 04/26/2022. Bolling stated that she is currently flushing the faucet four times per day for four weeks. At which point, the water faucet 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 Center Manager, Lashonda Bolling. 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.


SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
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)
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Document Has Been Signed on 05/20/2022 12:10 PM - It Cannot Be Edited


Created By: Nola Maestas On 05/20/2022 at 11:57 AM
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 - ELLIOTT RANCH
FACILITY NUMBER: 343617318

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
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 outlet is not in use. Center Manager stated that once she was informed, she took immediate action. Maintanence has repaired the faucet and re-testing is scheduled to occur in the next two weeks.
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The water report dated 04/25/2022 revealed that the facility had elevated levels of lead in one water faucet. 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: 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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