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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610025
Report Date: 03/06/2025
Date Signed: 03/06/2025 11:59:44 AM

Document Has Been Signed on 03/06/2025 11:59 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - WICKLUNDFACILITY NUMBER:
393610025
ADMINISTRATOR/
DIRECTOR:		NANDIRANJO, MADHURIFACILITY TYPE:
840
ADDRESS:300 EAST LEGACYTELEPHONE:
(209) 832-5834
CITY:MOUNTAIN HOUSESTATE: CAZIP CODE:
95391
CAPACITY: 70TOTAL ENROLLED CHILDREN: 25CENSUS: 0DATE:
03/06/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:31 AM
MET WITH:Madhuri NandiranjoTIME VISIT/
INSPECTION COMPLETED:
12:03 PM
NARRATIVE
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On March 6, 2025, Licensing Program Analyst (LPA) Stacey Williams met with Facility Representative, Lee McCowan for the purpose of conducting a case management inspection. There were no children present during the inspection. Criminal record clearances were verified.

LPA toured the facility and discussed an incident report submitted to Community Care Licensing on February 27, 2025. It was reported that on February 20, 2025, C1 was in a classroom with two staff, saw their parent and went to greet them without informing staff. Interviews conducted revealed that the C1 returned to the classroom with their parent and the gate leading to the parking lot was open. Staff reported they were handling an issue involving another child and did not notice C1 leave the classroom.

Facility Representative discussed the center’s policies and procedures during the inspection and reported adjustments have been made to the classroom to ensure safety is met at all times.

Title 22 Deficiencies have been cited on the attached LIC 8099D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Report LIC 809D in each child's files.

Exit interview conducted at which time the report was reviewed with Facility Representative, Lee McCowan. A Notice of Site Visit was posted by LPA Williams and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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Document Has Been Signed on 03/06/2025 11:59 AM - It Cannot Be Edited


Created By: Stacey Williams On 03/06/2025 at 11:17 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CATALYST KIDS - WICKLUND
FACILITY NUMBER: 393610025

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/07/2025
Section Cited
HSC
1596.99(c)(3)(c)

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The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues .... :(3) Absence of supervision, including, but not limited to, a child left unattended, and supervision of a child by a person under 18 years of age.
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Program Lead stated that supervision training was done with all staff. Within the training, Title 22 regulations were reviewed. The classroom area was rearranged to provide front door access only for parents. The floors and doors were labeled to notify children where to stop. Staff have daily check in meetings
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This requirement was not met as evidence by: Community Care Licensing was notified of an incident where a child, (c1) left the classroom without staff's knowledge and returned with their parent. This poses an immediate risk to the health and safety of children in care.
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with children regarding safety rules and procedures. Program Lead provided training material and roster during today's inspection. POC cleared---
Civil Penalty of five hunded follars($500.00) will be assess on the next page (LIC 421M)

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Bettina Engelman
LICENSING EVALUATOR NAME:Stacey Williams
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025


LIC809 (FAS) - (06/04)
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