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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573615405
Report Date: 10/29/2024
Date Signed: 10/29/2024 02:45:56 PM

Document Has Been Signed on 10/29/2024 02:45 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 - KOREMATSUFACILITY NUMBER:
573615405
ADMINISTRATOR/
DIRECTOR:		CINDY FLORESFACILITY TYPE:
840
ADDRESS:3100 LOYOLA DR.TELEPHONE:
(530) 753-9223
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 7DATE:
10/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:director, Ben PascaleTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Lauren Scott met with Director, Ben Pascale, to follow up on an Unusual Incident Report (UIR) that was reported to Community Care Licensing on 10/15/2024.

The facility reported the UIR to Community Care Licensing within 24hrs and submitted a written UIR within 7 days.

LPA interviewed the Director and teacher who were present during the incident. LPA reviewed and discussed this report with the Director.

Facility evaluation report was reviewed and discussed with the director. An 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.
Chayntel HunterTELEPHONE: (916) 917-8620
Lauren ScottTELEPHONE: (916) 926-9488
DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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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