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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610766
Report Date: 02/21/2024
Date Signed: 02/21/2024 03:43:50 PM

Document Has Been Signed on 02/21/2024 03:43 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - FREILERFACILITY NUMBER:
393610766
ADMINISTRATOR:ANOVA, LEONELYNFACILITY TYPE:
850
ADDRESS:2421 W LOWELL STREETTELEPHONE:
(209) 835-1869
CITY:TRACYSTATE: CAZIP CODE:
95377
CAPACITY: 48TOTAL ENROLLED CHILDREN: 21CENSUS: 0DATE:
02/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Leonelyn AnovaTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Corina Beckby met with Facility Representative, Leonelyn Anova, to follow up on the Unusual Incident Reports (UIR) submitted to Community Care Licensing on 06/28/23.

LPA toured the facility, interviewed staff, took pictures of the playground and measured the playground. Facility Representative stated there is no preschool during the summer and the report was written under the wrong license number. Facility Representative was asked to submit a corrected UIR with the correct license number.

Facility evaluation report was reviewed and discussed with Licensee. Exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during today's inspection.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
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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