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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343600894
Report Date: 01/26/2023
Date Signed: 01/26/2023 10:27:18 AM


Document Has Been Signed on 01/26/2023 10:27 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:CATALYST KIDS - FOULKS RANCHFACILITY NUMBER:
343600894
ADMINISTRATOR:GUZMAN, MARIAFACILITY TYPE:
840
ADDRESS:6211 LAGUNA PARK DRIVETELEPHONE:
(916) 684-0861
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:88CENSUS: 12DATE:
01/26/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maria GuzmanTIME COMPLETED:
10:30 AM
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Application Specialist (AS) Alecia Sifuentes met with Director, Maria Guzman for the purpose of a case management inspection. Licensee requests a change of capacity to serve 56 school-age children from kindergarten and above. The facility is located at Foulks Ranch Elementary School. The program operates Monday through Friday from 6:45 a.m. to 6:00 p.m. The fire clearance was granted and received on 1/10/2023.

A health and safety inspection was conducted in all areas accessible to children. Superintendent/Principal letter on file allowing the program to utilize classrooms 7 and 8. Per Health and Safety Code 1596.806, the facility is exempt from square footage requirement; therefore, AS did not take measurements. The children will use the school’s restrooms, and there is a separate private restroom for staff.

Licensee 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.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Maria Guzman.

Effective today, 1/26/2023, AS will approve the change of capacity for 56 school-age children.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2023
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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