343600894-1-4-2023-53-CC-NMAS-CMRRJ2-20230104120313

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343600894
Report Date: 01/04/2023
Date Signed: 01/04/2023 12:03:20 PM

Document Has Been Signed on 01/04/2023 12:03 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 - FOULKS RANCH		FACILITY NUMBER:	343600894
ADMINISTRATOR:	GUZMAN, MARIA		FACILITY TYPE:	840
ADDRESS:	6211 LAGUNA PARK DRIVE		TELEPHONE:	(916) 684-0861
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95758
CAPACITY:	88	CENSUS: 9	DATE:	01/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria Guzman		TIME COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst Katy Maestas (LPA1) and Licensing Program Analyst Chris Bello (LPA2) conducted a field visit to the facility for the purpose of an unannounced annual inspection. LPA1 disclosed the purpose of the inspection and was granted entrance into the facility. LPA1 and LPA2 met with the Director Maria Guzman (D1). LPAs toured the facility inside and outside. LPAs observed 9 school aged children supervised by 3 staff members. D1 stated that the school aged children who were present are off-track. LPA1 accessed Guardian to verify that all required adults were background cleared. LPAs observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday - Friday from 6:45 AM to 6:00 PM. The facility provides breakfast, lunch and snack for the off-track children, which is supplied by the school district. School aged children who arrive after school receive snack only. LPA1 conducted a file review prior to inspection and verified that annual fees were current. While on location, LPA1 reviewed care and supervision of children, staffing ratios, medications, first aid supplies, furniture, equipment, fire drills, and drinking water. LPAs observed all required forms to be posted. There appear to be adequate toys and equipment available for children. LPAs toured the outdoor play area, and the play equipment appeared to be in good repair. D1 confirmed that the next door park is also utilized for outdoor play; Field Trip forms are on record. LPA1 reviewed the sign in/out documents and observed that the children who were currently in-care were properly signed in. LPA1 reviewed children’s and staff files. LPA1 observed Health Screening Reports with TB test and required MMR and TDAP vaccines for all present staff members. At least one staff member present today had current Pediatric CPR and First Aid (exp. 03/17/2024). LPA1 observed current Mandated Reporter training for all present staff. D1 was reminded to renew the course every 2 years for all required staff members. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com. The training is currently provided in English and Spanish. Report Continues on 809-C

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola Maestas	TELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023

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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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 - FOULKS RANCH	FACILITY NUMBER: 343600894
	VISIT DATE: 01/04/2023

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Incidental Medical Services (IMS) policy was discussed with D1. For IMS information, see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

D1 was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, PRIOR to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

In the areas that were evaluated, no deficiencies were cited during today’s inspection. LPA1 conducted an Exit Interview and the report was reviewed with D1. 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 Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola Maestas	TELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023

LIC809 (FAS) - (06/04)

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