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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709462
Report Date: 12/09/2024
Date Signed: 12/09/2024 03:07:03 PM

Document Has Been Signed on 12/09/2024 03:07 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CATALYST KIDS - GARDEN GATEFACILITY NUMBER:
430709462
ADMINISTRATOR/
DIRECTOR:		MADHU PAULFACILITY TYPE:
840
ADDRESS:10500 ANN ARBOR AVENUETELEPHONE:
(408) 725-0269
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY: 84TOTAL ENROLLED CHILDREN: 33CENSUS: 19DATE:
12/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:18 PM
MET WITH:Candice RangelTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analysts (LPAs) Marilou Monico and Jaime Gonzales made a Case Management Inspection in response to an incident that was reported by the facility to Licensing involving a daycare child, C1. LPAs met with Program Lead, Candice Rangel, and explained to her the purpose of the inspection. LPAs conducted interviews, toured the playground, and obtained copy of sign in/out sheet.

Based on the information gathered during the inspection, there is no evidence to prove that a child's personal rights were violated or there was lack of supervision.

Exit interview conducted and report was reviewed with the Program Lead, Candice Rangel. No deficiencies issued. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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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