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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710217
Report Date: 10/15/2020
Date Signed: 10/16/2020 09:08:18 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CATALYST KIDS - CHERRY CHASEFACILITY NUMBER:
430710217
ADMINISTRATOR:SCHOLES, ALYSSAFACILITY TYPE:
840
ADDRESS:1138 HEATHERSTONE WAYTELEPHONE:
(408) 736-0168
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:140CENSUS: 8DATE:
10/15/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Alyssa ScholesTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Tuoc Doan conducted an announced Tele-Inspection via a video call with Director Alyssa Scholes. Facility was informed that due to the COVID-19 pandemic and "Shelter in Place" Order, this report will be emailed to the facility. Facility’s reply to the email will serve as acknowledgement that the report was received.

The Tele-Inspection is in response to Licensee's request to add rooms 36 and 38 and remove rooms 3 and 29 from the School-Age License. Furthermore, facility had changed their name from Cherry Chase School Age Program to Catalyst Kids – Cherry Chase. The licensed capacity remains at 140. A fire clearance was granted on 10/07/2020 for day care use of rooms 1, 2, 36 and 38.

The facility is currently operating on a functioning school site, Cherry Chase Elementary School. Per the School District, the rooms are considered usable and of sufficient size for instructional purposes for 35 children per room.

LPA observed that the rooms are furnished with furniture and equipment such as tables, chairs, sinks, hooks for backpacks, etc.

Based on today's Tele-Inspection, the following changes are approved, effective 10/16/2020:
1. Rooms 36 and 38 are added to the School-Age license;
2. Rooms 3 and 39 are removed from the School-Age license; and
3. Facility’s name changed to Catalyst Kids – Cherry Chase.

Exit interview was conducted and this report was reviewed over the video call with Director Alyssa Scholes.
A NOTICE OF SITE VISIT WAS ISSUE 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: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
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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