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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617318
Report Date: 01/27/2026
Date Signed: 01/27/2026 08:30:20 AM

Document Has Been Signed on 01/27/2026 08:30 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - ELLIOTT RANCHFACILITY NUMBER:
343617318
ADMINISTRATOR/
DIRECTOR:		ANTJUANETTE CARTERFACILITY TYPE:
850
ADDRESS:10000 EAST TARON DRTELEPHONE:
(916) 714-2313
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 24TOTAL ENROLLED CHILDREN: 17CENSUS: 6DATE:
01/27/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Antjuanette CarterTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
NARRATIVE
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Licensing Program Analyst (LPA) Corina Beckby met with Center Manager, Antjuanette Carter, to follow up on an Unusual Incident Report (UIR) submitted to Community Care Licensing on 12/23/2025. Sixpreschool aged children were present during today’s inspection

LPA Beckby toured the facility, observed the care and supervision of children, reviewed records and conducted on site interviews with Center Managers and teachers. The center self reported that on December 19, 2025, at approximately 9:45 am, Child #1 was pushed into a shelf by Child #2, resulting Child #1 needing medical attention. Through interviews and diagrams, the facility had enough supporting staff. At the time of the incident there were 4 staff members supervising 10-11 children, meeting Community Care Licensing teacher per child ratio. However, 2 staff members were sitting at the same table with 2 children, 1 staff member was sitting at another table with a larger group of children, and 1 staff member was prepping materials/table for another project. Staff did not communicate with each other when children were being dismissed/transitioned from one area to another and did not position themselves to anticipate the behavior from child #2 who was upset (as stated through interviews).

Based on the interview and information obtained, a Title 22 Deficiency has been issued on the attached LIC 809-D. LPA Beckby informed Center Manager, Antjuanette Carter that this report dated January 27, 2026, documents one (1) Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Beckby informed Center Manager to provide a copy of this licensing report dated January 27, 2026, that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Center Manager, Antjuanette Carter.

NAME OF LICENSING PROGRAM MANAGER: Bettina Engelman
NAME OF LICENSING PROGRAM ANALYST: Corina Beckby
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 01/27/2026 08:30 AM - It Cannot Be Edited


Created By: Corina Beckby On 01/16/2026 at 09:17 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CATALYST KIDS - ELLIOTT RANCH
FACILITY NUMBER: 343617318

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/28/2026
Section Cited
CCR
101229(a)(1)

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(a) The licensee shall provide care and supervision... (1) No child(ren) shall be left without the supervision of a teacher at anytime... Supervision shall include visual observation. This requirement was not met as evidenced by:
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Staff meeting was conducted by acting Center ManagerJennifer Tydingco on 12/22/2025 regarding supervision of children. Staff meeting was conducted on 01/13/2026 by Center Manager Antjuanette Carter
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Based on interviews, there was sufficient staff, but did not communicate with each other and did not position themselves in a manner to anticipate behavior of Child 1 who physically injured Child 2, requiring medical attention.
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regarding Title 5 and Title 22 regulations and ratios, shared regarding responsibilities, effective communication, conducting head counts every 15 min and documenting every 30 min., and zoning/positioning in and outside the classroom.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Bettina Engelman
NAME OF LICENSING PROGRAM MANAGER:
Corina Beckby
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2026


LIC809 (FAS) - (06/04)
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