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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393615867
Report Date: 09/07/2023
Date Signed: 09/07/2023 02:29:56 PM


Document Has Been Signed on 09/07/2023 02:29 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:MULIT, CATALINAFACILITY NUMBER:
393615867
ADMINISTRATOR:MULIT, CATALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 688-3367
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY:14CENSUS: 4DATE:
09/07/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Licensee Catalina MulitTIME COMPLETED:
03:00 PM
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On 9/7/23, Licensing program Analyst (LPA) Carla Polanco conducted an unannounced case-management visit and met with Licensee Catalina Mulit. LPA was granted entry by Licensee. Today's inspection was for the purpose of converting the off-limit backyard in the FCCH back to an on-limit area. There were 4 children present during the inspection, being supervised by Licensee.

During the inspection, LPA observed the backyard to be in safe conditions. LPA also observed workout equipment in a fenced off area that is inaccessible to children. As of today, 9/7/23 the backyard is on limit and will be included as part of the FCCH. LPA will update the License and send to Licensee. There is a play structure with swings in the backyard, age requirements were discussed. Licensee understands that children under the structure age limits are not allowed on the structure for the children's safety.

Exit interview conducted and report was reviewed with the licensee. 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.

In the areas that were evaluated, no deficiencies were cited during today’s inspection.
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Carla Polanco RiveraTELEPHONE: (916) 212-0752
LICENSING EVALUATOR SIGNATURE:
DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/07/2023
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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