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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201349
Report Date: 04/23/2024
Date Signed: 04/23/2024 04:06:05 PM

Document Has Been Signed on 04/23/2024 04:06 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, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:CATALYST CARES ADULT DAY PROGRAMFACILITY NUMBER:
079201349
ADMINISTRATOR/
DIRECTOR:		FREEMAN, MAVISFACILITY TYPE:
775
ADDRESS:3905 SAN PABLO DAM ROADTELEPHONE:
(510) 390-5538
CITY:EL SOBRANTESTATE: CAZIP CODE:
94803
CAPACITY: 60CENSUS: 0DATE:
04/23/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Mavis Freeman, CEO/Administrator TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 04/23/24 around 09:00 AM. Lisha Holmes, Licensing Program Analyst (LPA) arrived announced to conduct a pre-licensing inspection. LPA met with Mavis Freeman, CEO/Administrator (ADM) and explained the purpose of the visit. Currently, the facility does not have any clients.

LPA and ADM toured the facility including but not limited to the receptionist area, computer/library that offers computer usage, books, a sitting area and educational resources Monday through Friday. LPA observed infection control compliancy with covered garbage cans, PPE, a thermometer, hand sanitizer, and linens. There is a separate room with a washer and dryer that offers an alternate space to provide bedding if isolation is needed. The facility also offers a zen room with pedicure care, a multimedia room, a game room that includes sensory items, swings, basketball, boxing bags and a variety of board games. The exercise room offers a WII gaming system, stationary exercise bikes, light weights and an area to relax. The conference room also serves as a retreat for clients. The facility has adequate lighting throughout that lends additional lighting for the FAME area that offers karaoke, a 360 photo carousel and provides props to dress-up to take and print photos.
Continued on LIC809C...
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: CATALYST CARES ADULT DAY PROGRAM
FACILITY NUMBER: 079201349
VISIT DATE: 04/23/2024
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...continued from LIC809

Indoor and outdoor passageways were observed free of obstruction. There were no bodies of water observed. LPA observed the water at 108.9 degrees F. LPA observed a 30-day emergency food supply of non-perishable foods, and portable gas stove. The facility has separate bathrooms for men and women with grab-bars, non-skid floors and the entire facility is wheelchair accessible. The facility has flashlights available for emergency use. First-aid kits are complete, and smoke and carbon monoxide detectors were operational. Fire extinguishers were last inspected 10/03/23. Emergency Disaster plans/contact information, personal rights and hand-washing signs will be posted in the facility.

No deficiencies were noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided to ADM.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
LIC809 (FAS) - (06/04)
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