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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570310386
Report Date: 08/24/2021
Date Signed: 08/24/2021 11:13:16 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:CATALYST KIDS - CESAR CHAVEZFACILITY NUMBER:
570310386
ADMINISTRATOR:MONROE, MARY ALLISONFACILITY TYPE:
840
ADDRESS:1221 ANDERSON ROADTELEPHONE:
(530) 753-3808
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY:124CENSUS: 0DATE:
08/24/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Nicole RoweTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Amy Silva conducted an announced case management visit and met with Director, Nicole Rowe. The purpose of today’s visit was to inspect and approve the Multipurpose room to temporarily be utilized by staff and children. The two main portables are under construction and not estimated to be ready for children until December 2021. Facility will utilize rooms 30, 31 and the Multipurpose room while construction is being completed. The capacity of 124 will remain the same. The Department has an approved fire clearance on file to utilize the multipurpose room.

As of 8/24/2021 the facility is approved to utilize rooms 30, 31 and the Multipurpose room.

Exit interview conducted with Nicole Rowe. Notice of site visit was provided and must be posted for 30 days.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Amy SilvaTELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
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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