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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
483004464
Report Date:
05/29/2024
Date Signed:
05/29/2024 12:52:21 PM
Document Has Been Signed on
05/29/2024 12:52 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
,
520 COHASSET RD., SUITE 170
CHICO
,
CA
95926
FACILITY NAME:
CATALYST KIDS - GRETCHEN HIGGINS SCHOOL-AGE
FACILITY NUMBER:
483004464
ADMINISTRATOR/
DIRECTOR:
CHAVEZ, ESTHELA
FACILITY TYPE:
840
ADDRESS:
1465 PEMBROKE WAY
TELEPHONE:
(707) 678-8919
CITY:
DIXON
STATE:
CA
ZIP CODE:
95620
CAPACITY:
70
TOTAL ENROLLED CHILDREN:
70
CENSUS:
43
DATE:
05/29/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:
Diana Esparza
TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 5/29/2024 at 12:15pm LPA Laura Chavez conducted a case management inspection to the facility and met with Regional Director Diana Esparza. During today's inspection LPA took measurements of Classroom #1.
There is one toilet and 2 sinks available for children.
A notice of site visit was given and must remain posted for 30 days.
An exit interview conducted and report was reviewed with Regional Director Diana Esparza.
SUPERVISORS NAME
:
Megan Aviles
LICENSING EVALUATOR NAME
:
Laura Chavez
LICENSING EVALUATOR SIGNATURE
:
DATE:
05/29/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/29/2024
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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