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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620604
Report Date: 03/11/2024
Date Signed: 03/11/2024 11:02:52 AM

Document Has Been Signed on 03/11/2024 11:02 AM - 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 - SUNSET RANCHFACILITY NUMBER:
313620604
ADMINISTRATOR:KRISTIE BRANTLEYFACILITY TYPE:
850
ADDRESS:2500 BRIDLEWOOD DRTELEPHONE:
(916) 778-3086
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
03/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lien LuiTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Lien Lui for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPA observed 18 children supervised by three staff members.

It was reported that on 02/28/2024, child #1 suffered a cut lip and falling inside the classroom. It was reported that child 1 tripped over staff 1’s foot while they running inside the classroom. The child’s lip was bleeding, and their parents were contacted. The child was seen at the dentist and was not observed to have any missing teeth or other oral injuries other than a cut lip.

LPA interviewed staff 1 during today’s inspection and observed the area where the injury occurred.

An exit interview was conducted, and this report was reviewed with facility representative Lien Lui. LPA provided a Notice of Site Visit that should remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2024
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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