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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709504
Report Date: 03/13/2025
Date Signed: 03/13/2025 10:20:08 AM

Document Has Been Signed on 03/13/2025 10:20 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CATALYST KIDS - LOS ALAMITOSFACILITY NUMBER:
430709504
ADMINISTRATOR/
DIRECTOR:		CARRIE SMITHFACILITY TYPE:
840
ADDRESS:6130 SILBERMAN DRIVETELEPHONE:
(408) 268-6331
CITY:SAN JOSESTATE: CAZIP CODE:
95120
CAPACITY: 105TOTAL ENROLLED CHILDREN: 105CENSUS: 0DATE:
03/13/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Merisa ColonTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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At 8:00 AM, Licensing Program Analyst (LPA) Andy Yang, and Licensing Program Manager (LPM), Belinda Devall, met with Teacher, Merisa Colon and Site Director, Carrie Smith, for an unannounced case management-incident. Purpose of today's investigation was to discuss an incident of a child that occurred on February 24, 2025. The day care is located on campus of the Los Alamitos Elementary school. LPA and LPM inspected the outdoor playground area. The play structure has resilient material on the grass turf. LPA observed a sign for the play structure which states that it is designed for children 5 to 12 years old.

During today's investigations, LPA interviewed staff S1 and the site director.

Based on today's interviews, staff observed the incident, administered First Aid to the child, and contacted parents. Site Director had made prompt changes to supervision of the outdoor activities around the play structure and limited the play area of the structure to reduce risk of injuries.

No deficiencies issued and (1) Technical Assistance issued during today's investigation. Please see attached advisory note pages for information on technical assistance issued today for best practices to maintain compliance.

Technical Assistance:
  • Teachers shall provide proper supervision during outdoor activities around the play structure in high traffic areas and ensure children are properly using the play structure to minimize injuries.


A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Carrie Smith.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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