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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573600620
Report Date: 01/03/2024
Date Signed: 01/03/2024 02:50:05 PM

Document Has Been Signed on 01/03/2024 02:50 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - GIBSONFACILITY NUMBER:
573600620
ADMINISTRATOR:BEN PASCALEFACILITY TYPE:
840
ADDRESS:312 GIBSON ROADTELEPHONE:
(530) 666-4822
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 22DATE:
01/03/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Site Supervisor, Ben PascaleTIME COMPLETED:
03:05 PM
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Licensing Program Analyst (LPA) Lauren Scott met with Site Supervisor, Ben Pascale, for the purpose of an unannounced annual inspection. There were 22 children present at the time of the inspection. Facility days and hours of operation are Monday - Friday from 7:00 AM to 6:00 PM. LPA reviewed the sign in/out book and observed that the children are properly signed in/out.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA toured the facility inside and out. LPA observed that hazardous items were inaccessible to children in care. LPAs observed the following items during today's inspection: care and supervision of children, staffing ratios, first aid supplies, furniture, equipment, and access to drinking water. LPA also observed all required forms to be posted. Facility provides breakfast, lunch and snack to children in care. All food is prepared on site. LPA toured the kitchen at time of inspection.

Facility shares an outdoor play area with the elementary school. LPA toured the play area, the play structure appeared to be in good repair, and there is sufficient cushioning (wood chips) under the play structure.

LPA observed health screening reports with TB test and required MMR and TDAP vaccines. At least one staff member present today has current Pediatric CPR and First Aid. LPA observed AB1207 mandated reporter training certificates for all staff. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.
Report continues on 809-C.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2024
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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