<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573615405
Report Date: 01/30/2024
Date Signed: 01/30/2024 01:33:47 PM

Document Has Been Signed on 01/30/2024 01:33 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:CINDY FLORESFACILITY TYPE:
840
ADDRESS:3100 LOYOLA DR.TELEPHONE:
(530) 753-9223
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: DATE:
01/30/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Site Supervisor, Cindy FloresTIME COMPLETED:
01:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Lauren Scott and Licensing Program Manager (LPM) Chayntel Hunter, met with Site Supervisor, Cindy Flores to conduct an unannounced case management inspection.

On 1/26/24, LPA Lauren Scott received a phone call from Site Supervisor, Cindy Flores to report an Unusual Incident Report (UIR) regarding a staff who inappropriately disciplined a child.

LPA conducted interviews with staff and children. Interviews revealed that one teacher inappropriately disciplined a child. The teacher took a book from the child's hands and tossed, and proceeded to talk to them in a stern tone of voice.

An exit interview was conducted with the Site Supervisor. 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.



LPA Scott informed Site Supervisor, Cindy Flores, that this report dated 1/30/24 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Scott informed the Site Supervisor, Cindy Flores, to provide a copy of this licensing report dated 1/30/24, that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 01/30/2024 01:33 PM - It Cannot Be Edited


Created By: Lauren Scott On 01/30/2024 at 01:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CATALYST KIDS - KOREMATSU
FACILITY NUMBER: 573615405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/01/2024
Section Cited
CCR
101223(a)(3)

1
2
3
4
5
6
7
The licensee shall ensure that each child is accorded the following personal rights:
To be free from corporal or unusual punishment... humiliation, intimidation.... or other actions of a punitive nature including but not limited to... This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility will hold a staff meeting regarding how to appropriately discipline children. Facility will submit proof of meeting with staff signatures to LPA.
8
9
10
11
12
13
14
LPA recevied a phone call regarding a UIR. The facility stated a child had been innappropraitely disciplined by a staff. Facility stated the parents were notified and the staff had been placed on administrative leave.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chayntel Hunter
LICENSING EVALUATOR NAME:Lauren Scott
LICENSING EVALUATOR SIGNATURE:
DATE: 01/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2