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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410784
Report Date: 12/01/2022
Date Signed: 12/01/2022 02:05:21 PM

Document Has Been Signed on 12/01/2022 02:05 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CATALYST KIDS - GARDEN GATEFACILITY NUMBER:
434410784
ADMINISTRATOR:MADHU PAULFACILITY TYPE:
850
ADDRESS:10500 ANN ARBOR AVENUETELEPHONE:
(408) 725-0269
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:44 PM
MET WITH:Madhu PaulTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Marilou Monico met with Madhu Paul, Program Lead, for an unannounced Required - 1 Year Inspection. LPA explained to Madhu the purpose of today's inspection. LPA observed all the required posted materials. The preschool program is licensed in Room 21. Days and hours of operation are Monday thru Friday from 9 AM to 12:00 PM. Program Lead states that there are no children currently enrolled in the preschool program but licensee wants to keep the license on active status.

The indoor and outdoor areas of the facility were inspected. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Cleaning products are stored in a locked cabinet under the sink in the kitchen located in Room 21. There are two bathrooms with one toilet and one sink in each bathroom in Room 21 available for the children. There is a separate staff bathroom with one toilet and one sink in Room 21. Sick children will use the staff bathroom if needed.

Program Lead states that there are no weapons or firearms in the facility. Drinking water is readily available for the children indoor and outdoor via individual water bottles. The preschool children will use the playground in front of Rooms 20 & 21. The playground has climbing structures with tanbarks as resilient material underneath and around the structures. Shades are provided by trees. There were no bodies of water observed.

Program Lead has immunization in measles, pertussis, and flu. Madhu has current CPR/First certification with an expiration date of September 24, 2024. Program Lead's Mandated Reporter Training has an expiration date of April 8, 2024. LPA reminded Program Lead that Mandated Reporter Training must be reviewed by all staff every two years.

Continuation on next page:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CATALYST KIDS - GARDEN GATE
FACILITY NUMBER: 434410784
VISIT DATE: 12/01/2022
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This facility has Incidental Medical Services – IMS on file. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Program Lead was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

As a result of this inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with Madhu Paul, Program Lead.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
LIC809 (FAS) - (06/04)
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