393604765-3-15-2023-53-CC-SWIS-CPXRVS-20230315132203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393604765
Report Date: 03/15/2023
Date Signed: 03/15/2023 01:22:08 PM

Document Has Been Signed on 03/15/2023 01:22 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 - JACOBSON		FACILITY NUMBER:	393604765
ADMINISTRATOR:	MASTROPIERRO,MALISSA		FACILITY TYPE:	840
ADDRESS:	1750 KAVANAGH STREET		TELEPHONE:	(209) 832-8799
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	70	CENSUS: 0	DATE:	03/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:19 AM
MET WITH:	Andiana Serrano		TIME COMPLETED:	01:10 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 (LPA) Stacey Williams met with Program Lead, Andiana Serrano for the purpose of an unannounced 1 Year Required inspection. Upon arrival, there were 2 staff and no children present. Facility hours of operation are Monday through Friday from 6:30 am to 6:30 pm. All staff present during today's inspection have a fingerprint clearance. Program Lead 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. LPA toured classrooms, restrooms, and outdoor play areas. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Toxic and hazardous items are inaccessible to children. Facility maintains a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. Furniture and equipment are in good condition and all toys are age appropriate. LPA observed regularly conducted fire drills. Sign in and Out procedures are done electronically. LPA also observed all required postings are in the facility. There is also a complete First Aid kit. All food was protected against contamination and stored appropriately. Storage containers with solid waste have tight-fitting covers. The program provides breakfast and super snack. Menus were posted. Drinking water was readily available to children both indoors and outdoors by way of water jugs and disposal cups. Program Lead stated that the facility conducted water testing for lead in the summer of 2022. Report continued on LIC809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

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 - JACOBSON	FACILITY NUMBER: 393604765
	VISIT DATE: 03/15/2023

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LPA reviewed 5 children and 3 staff files. LPA observed complete files, including health screening reports with TB test and required MMR and TDAP vaccines. At least one staff member present today has current Pediatric CPR and First Aid (expiration 10/23). LPA observed current AB1207 mandated reporter training certificates for all staff. Program Lead was reminded that staff must renew this certification every 2 years through the www.mandatedreporterca.com website.

Incidental Medical Services (IMS) was discussed. There are currently no children enrolled that require IMS.
LPA also advised that information regarding ADA can be located by calling: US Department of Justice’s toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY). Commonly Asked Questions about Child Care Centers and the ADA, is available at: http://www.ada.gov/childqanda.htm.

To improve the quality and value of the new inspection process, a survey will be sent to the email address on file. Please complete the survey and share your inspection experience. 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. Finally, Center Manager was encouraged to the visit the Department's website at www.cdss.ca.gov for information regarding childcare updates, forms, regulations, and legislation pertaining childcare centers.

In the areas that were evaluated, no deficiencies were cited during the inspection.

An Exit interview was conducted, and the report was reviewed and provided to Program Lead, Andiana Serrano. LPA posted the Notice of Site Visit and Center Manager acknowledges it must remain posted for 30 days. A failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

LIC809 (FAS) - (06/04)

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