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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573615663
Report Date: 01/03/2024
Date Signed: 01/03/2024 02:50:29 PM

Document Has Been Signed on 01/03/2024 02:50 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CATALYST KIDS - GIBSONFACILITY NUMBER:
573615663
ADMINISTRATOR:BEN PASCALEFACILITY TYPE:
850
ADDRESS:312 GIBSON ROADTELEPHONE:
(530) 666-4822
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
01/03/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Site Supervisor, Ben PascaleTIME COMPLETED:
03:05 PM
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Licensing Program Analyst (LPA) Lauren Scott met with Site Supervisor, Ben Pascale for the purpose of an unannounced annual inspection. Facility days and hours of operation are Monday-Friday from 8:30 AM to 11:30 AM. There were 0 children present during today's inspection. LPA reviewed the sign in/out book and observed that the children are properly signed in.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA toured the facility inside and out. LPA observed that all hazardous items were inaccessible to children in care. LPA reviewed staffing ratios, first aid supplies, fire drills and drinking water. LPA observed the furniture and equipment to be in good condition. LPA observed all required forms to be posted. LPA observed functioning carbon monoxide and smoke alarms. There are adequate toys and equipment available for children. Outdoor play area was toured. Play equipment appears to be in good condition Facility provides snack to children in care. All food is prepared on site. Kitchen was toured at the time of inspection.

LPA reviewed children’s and staff files. LPA observed health screening reports with TB test and required MMR and TDAP vaccines for all adults and children. At least one staff member present today has current Pediatric CPR and First Aid. LPA observed AB1207 Mandated Reporter training certificates for all staff. The site supervisor was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

Report continues on 809-C

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2024
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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