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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343608112
Report Date: 05/18/2023
Date Signed: 05/18/2023 03:10:26 PM

Document Has Been Signed on 05/18/2023 03:10 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:CATALYST KIDS - ELLIOTT RANCHFACILITY NUMBER:
343608112
ADMINISTRATOR:SHAYLA WILLIAMS-BARNESFACILITY TYPE:
840
ADDRESS:10000 EAST TARON DRTELEPHONE:
(916) 714-2313
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 18DATE:
05/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Nancy Torres AcevedoTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Corina Beckby met with Center Manager, Nancy Torres Acevedo to follow up on the Unusual Incident Reports (UIR) submitted to Community Care Licensing on 5/16/23.

LPA toured the facility, observed the care and supervision of children, reviewed records, obtained personnel roster, family roster and conducted interviews.

Facility evaluation report was reviewed and discussed with Center Manager.. Exit interview was conducted. 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.

In the areas that were evaluated, no deficiencies were cited during today's inspection.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2023
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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