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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483006341
Report Date: 12/15/2022
Date Signed: 12/15/2022 02:20:23 PM


Document Has Been Signed on 12/15/2022 02:20 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:CATALYST KIDS-GLEN RICHARDSONFACILITY NUMBER:
483006341
ADMINISTRATOR:PARIS SMITHFACILITY TYPE:
850
ADDRESS:1069 MEADOWLARK DRIVETELEPHONE:
(707) 426-4749
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:45CENSUS: 8DATE:
12/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Mia JohnsonTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Mia Johnson to conduct a case management inspection to measure the square footage of the indoor activity area. The facility is requesting a capacity increase from 45 to 48 preschool age children.

The is sufficient indoor activity square footage to support 48 children

The fire inspection is scheduled for Monday, 12/19/2022. Upon receipt of the approved fire inspection, the facility can be approved for a maximum capacity of 48 children.

No deficiencies cited during the visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
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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