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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621304
Report Date: 06/12/2024
Date Signed: 06/12/2024 09:37:25 AM

Document Has Been Signed on 06/12/2024 09:37 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 - PLEASANT GROVEFACILITY NUMBER:
343621304
ADMINISTRATOR/
DIRECTOR:		TYDINGCO, JENNIFERFACILITY TYPE:
850
ADDRESS:10160 PLEASANT GROVE SCHOOL RDTELEPHONE:
(916) 686-1260
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 7DATE:
06/12/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Jennifer TydingcoTIME VISIT/
INSPECTION COMPLETED:
09:45 AM
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On 06/12/24, Licensing Program Analyst (LPA) Jennie Tedlos met with Director Jennifer Tydingco. LPA was granted entrance to the facility. The purpose of today’s visit was to amend two 809 reports along with the two 809-D reports attached which were originally created on 06/07/24. During today's visit there were 7 children present being supervised by 2 staff members.

On LPA's visit with the facility on 06/07/24, LPA mistakenly labeled the type of visit on the 809 and 809-D page as "Annual/Random" instead of "Case Management-Incident". LPA conducted another visit at a different facility in the same day on 06/07/24 and mistakenly assigned their 809 and 809-D report to this (Catalyst-Pleasant Grove) facility.

This report along with the amended reports were reviewed with the Director. 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: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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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