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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313624426
Report Date: 07/19/2024
Date Signed: 07/19/2024 02:11:45 PM

Document Has Been Signed on 07/19/2024 02:11 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 - QUARRY TRAILFACILITY NUMBER:
313624426
ADMINISTRATOR/
DIRECTOR:		KRISTIE BRANTLEYFACILITY TYPE:
840
ADDRESS:810 LAZY TRAIL DRIVETELEPHONE:
(916) 286-7865
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 20DATE:
07/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Maria Garcia-CancholaTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analysts (LPAs) Jeremey McClain with facility representative Maria Garcia-Canchola for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPAs observed 20 children supervised by five staff members.

On 7/18/2024, facility representative reported an Unusual Incident to the officer of the day at the Sacramento Regional Office. It was reported that on 07/18/2024 child 1 was injured after they fell off a play structure on the playground. The facility was attending the playground as a part of a field trip. Staff 1 immediately attended to child 1, who did not initially show an injury. After 30 minutes, child 1’s elbow began to swell, and their parents were contacted. The child was diagnosed with a fractured elbow, which will require a cast. A case management was done today to assess the possibility of lack of supervision or potential hazards on the playground. LPA interviewed staff, observed the playground, and reviewed children’s files. LPA determined that the incident was not due to a lack of supervision, or failure to prevent hazards. LPA discussed safety measures with facility representative.

An exit interview was conducted, and the report was reviewed with facility representative Maria Garcia-Canchola. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2024
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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