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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393607697
Report Date: 03/22/2024
Date Signed: 03/22/2024 02:43:08 PM

Document Has Been Signed on 03/22/2024 02:43 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - SOUTH SCHOOLFACILITY NUMBER:
393607697
ADMINISTRATOR:RHOADES, MARTIFACILITY TYPE:
840
ADDRESS:500 WEST MOUNT DIABLOTELEPHONE:
(209) 834-1725
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 70TOTAL ENROLLED CHILDREN: 47CENSUS: 10DATE:
03/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Markie CwikTIME COMPLETED:
03:05 PM
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On March 22, 2024 , Licensing Program Analyst (LPA) Stacey Williams met with Facility Representative, Markie Cwik for the purpose of an unannounced annual inspection. The facility is located in portables (Rm #1 and Rm #2) on the campus of South Park Elementary School. Program hours are Monday through Friday 6:30AM-6:30PM. There were (10) ten children present during the inspection being supervised by three staff. Criminal record clearances have been verified.

LPA conducted a health and safety inspection for all areas accessible to children. Staff stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. LPA observed a functional carbon monoxide detector and a fully charged 3A :40BC fire extinguisher. The floors appeared clean throughout the facility. Outdoor play area is free from dangerous conditions and playground equipment is securely anchored to the ground. Facility has bark under the play equipment to absorb falls. The program provides breakfast and super snack. The facility operates during school breaks. Menus were posted on the refrigerator of the facility as well at the front entry of the facility. Facility offers drinking water by utilizing a water dispenser where each child’s individual cup is filled. Sign in/out sheets are done electronically. Fire drills are conducted monthly. The last drill was done 3/2024.

Child files were reviewed. Each child’s file included information pertaining to their authorized representative, consent for medical treatment, immunization records, and a medical assessment form. Files for staff who were present at the facility were reviewed. Mandated Reporter training completion certificates, Health screening report, immunization records, and documentation of their educational background, training, and/or experience was verified in files. CPR/ First Aid certification was verified for staff present. Site Supervisor has a CPR/First Aid expiration date of 2/2026.


LPA reviewed the Department's inspection authority and discussed with staff any changes that may occur regarding Director/Site Supervisor or an employee acting in the director's absence must be reported to department within 10 working days.

Report continues on LIC 809C

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CATALYST KIDS - SOUTH SCHOOL
FACILITY NUMBER: 393607697
VISIT DATE: 03/22/2024
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The Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries 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.

No citations were issued based on today’s inspection. Exit interview conducted and report was reviewed with the Facility Representative, Markie Cwik. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights provided.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC809 (FAS) - (06/04)
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