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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709552
Report Date: 11/17/2022
Date Signed: 11/17/2022 12:51:48 PM


Document Has Been Signed on 11/17/2022 12:51 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:CATALYST KIDS - NIMITZFACILITY NUMBER:
430709552
ADMINISTRATOR:FRANCISCO, FRANCZESCAFACILITY TYPE:
840
ADDRESS:545 CHEYENNE DRIVETELEPHONE:
(408) 736-6176
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:86CENSUS: 17DATE:
11/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Beatriz MartinezTIME COMPLETED:
01:20 PM
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On 11/17/2022; Licensing Program Analysts (LPA) Pete Hernandez, made a case management inspection in response to an unusual incident that was self-reported to Licensing by Regional Director, Kathy Abady, on 4/26/22. LPA explained the purpose of the subsequent visit to the Temporary Site Supervisor Beatriz Martinez and explained the purpose of the visit.

The Unusual Incident Report was regarding the following:

C1 and C2 reported inappropriate touching occurred between them; however, based on their statements, it was unclear whether this occurred during public school hours at Nimitz Elementary School or at Catalyst Kids (after-school program). C1 reported there were multiple incidents; however, C2 reported only one incident. C2 said that there was a child named C3 who was with them when she and C1 inappropriately touched their private areas; however, teachers reported this C3 was never a part of their program, they never seen or met her, and C3 was a student at Nimitz Elementary School.

Staff reported they did not observe inappropriate interactions between child C2 and child C1 while under their supervision. Children and parents interviewed did not report inappropriate behaviors or concerns either.

Since the event cannot be proven or disproved the reported incident is considered unsubstantiated, which means Based on the LPA’s and IB's, investigation Bureau's, observations, interview statements and information obtained throughout the investigation, the incident report issue is UNSUBSTANTIATED. Although the reported incident may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the reported Incident findings are UNSUBSTANTIATED.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CATALYST KIDS - NIMITZ
FACILITY NUMBER: 430709552
VISIT DATE: 11/17/2022
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No Deficiencies have been cited. Exit interview conducted with The Director, Beatriz Martinez. Copies of this report were provided to the Director.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
LIC809 (FAS) - (06/04)
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