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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620603
Report Date: 02/04/2025
Date Signed: 02/04/2025 01:10:00 PM

Document Has Been Signed on 02/04/2025 01:10 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - RUHKALAFACILITY NUMBER:
313620603
ADMINISTRATOR/
DIRECTOR:		ERIKA TREVINOFACILITY TYPE:
840
ADDRESS:6530 TURNSTONE WAYTELEPHONE:
(916) 632-6560
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 88TOTAL ENROLLED CHILDREN: 88CENSUS: 0DATE:
02/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Erika TrevinoTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Erika Trevino for an unannounced Case Management Inspection regarding an Unusual Incident Report that was reported on 01/16/2025.

No children were present at the time of inspection.

It was reported that on 01/15/2025 a child suffered two chipped teeth after tripping over another child’s foot while playing soccer. The child was immediately attended to and given the proper care before they were picked up. The child later received dental services for their injuries. Neither the child nor the staff involved in the incident were available today for an interview. LPA reviewed the incident report given to the child’s guardian for consistency. LPA observed the area that the incident occurred.

An exit interview was conducted, and the report was reviewed with facility representative Erika Trevino. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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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