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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620604
Report Date: 01/26/2023
Date Signed: 01/26/2023 01:23:33 PM

Document Has Been Signed on 01/26/2023 01:23 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:CATALYST KIDS - SUNSET RANCHFACILITY NUMBER:
313620604
ADMINISTRATOR:SHUBRHA CHOUDHURYFACILITY TYPE:
850
ADDRESS:2500 BRIDLEWOOD DRTELEPHONE:
(916) 778-3086
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
01/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Shubrha ChoudhuryTIME COMPLETED:
01:45 PM
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On January 26th, 2023, Licensing Program Analyst (LPA) Jeremey McClain met with Licensing Representative Shubhra Choudhury an unannounced Case Management Inspection regarding an Unusual Incident Reported.

No children were present during the inspection.

On January 4th, 2023, an Unusual Incident Report was received detailing an incident that occurred on 12/28/2022. It was reported that while two staff were supervising eight children, one staff member left the classroom area to escort a child to the bathroom. At the time, the site supervisor was in the kitchen when she realized that the staff member had left the group of children. The site supervisor stated that she immediately informed the staff member that she should not leave the children, and that she will provide supervision for the child that is going to the bathroom. The site supervisor stated that the group of children were left for less than a minute, but she was still able to have audio and visual supervision of the children in classroom area.

The facility uses bathrooms located inside of the portables on the opposite side of the kitchen. LPA observed that staff are able to provide supervision of the bathroom and classroom by standing in the door that divides the classroom and the kitchen. There is also a direct line of site from the kitchen to the classroom area.

LPA determined that there was not a lack of supervision, therefore no Title 22 deficiencies will be cited.

This report was reviewed with the licensing representative. LPA provided a Notice of Site Visit, which must remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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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