300614059-10-22-2021-06-CC-ECOL-C82V2L-20211022160319

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300614059
Report Date: 10/22/2021
Date Signed: 10/22/2021 04:03:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CATALYST KIDS-TURTLE ROCK		FACILITY NUMBER:	300614059
ADMINISTRATOR:	HO, MINDY		FACILITY TYPE:	840
ADDRESS:	5151 AMALFI DRIVE		TELEPHONE:	(949) 854-5060
CITY:	IRVINE	STATE: CA	ZIP CODE:	92603
CAPACITY:	70	CENSUS: 23	DATE:	10/22/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Director - Mindy Ho		TIME COMPLETED:	04:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/22/2021 Licensing Program Analyst (LPA) Corral conducted a Case Management Inspection to investigate an Unusual Incident Report (UIR) which was self-reported to our office on 10/20/2021. Prior to entering the Facility LPA Corral reviewed the COVID-19 Questionnaire with Staff Supervisor, Mindy Ho. Upon entry to the facility, LPA Corral met with Mindy Ho, where 23 school children were observed in care with 3 staff members providing care and supervision. Due to COVID 19 Guidelines, LPA Corral observed staff members wearing face masks, social distancing and following CDC and Dept of Public Health Guidelines. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. A review of the Facility Personnel Report Summary on 10/22/2021 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. According to the self-report incident received in our office, a 9-year-old child (C1) left home from care without informing staff or checking out. The incident report stated C1 arrived at the facility and checked in with the Site Supervisor, Mindy Ho. C1 then asked if he was supposed to be in care that day. Site Supervisor checked in with C1’s Mother and mother stated Yes, that C1 was to stay in the Facility for care. The UIR stated that Mindy Ho was supervising C1’s group and at about 3:00ish Mindy realized the child was not in the classroom. Site Supervisor then called C1’s Mother to ask if C1 had walked home. Mother informed Site Supervisor that she would go home to see if child was there. Facility contacted the Irvine Police Department to report the missing child. Mother stated when she arrived home, the child was at home. Mother returned to the Facility to pick up C1’s sibling. Child’s mother was interviewed by Irvine Police Officer. During today’s inspection, LPA Corral interviewed Program Director Christy Pate and Site Supervisor Mindy Ho. Director Christy Pate stated this has never happened before. During the Interview with Site Supervisor, Mindy Ho stated C1 arrived to the Facility at 1:44PM and Mindy asked C1 if he was to attend care and C1 replied Yes. Continue to Page 2.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CATALYST KIDS-TURTLE ROCK	FACILITY NUMBER: 300614059
	VISIT DATE: 10/22/2021

NARRATIVE

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C1 then came to Mindy and wanted to confirm if he had to stay, C1 asked Mindy to text C1's Mother and confirm if he had to stay. Mindy texted C1's Mother at 2:08 PM to confirm and Mother replied at 2:16PM saying Yes, C1 was to stay in care. Mindy spoke to C1 face to face at 2:18PM and confirmed with child that he was to stay. Site Supervisor stated she saw C1 playing Legos in the back of the room at about 2:30 PM and asked him to clean up and get ready for homework time. Child picked up the Legos and Mindy stated she does not recall seeing C1 during homework time. Mindy stated she realized C1 was gone during outside play time at about 3:20 PM. Site Supervisor stated she believes C1 left after clean up time, right before homework time.

Based on information gathered and LPA Corral’s interviews with Program Director Christy Pate and Site Supervisor Mindy Ho it has been determined that Facility failed to provide care and supervision for C1. The Facility was unaware of C1’s whereabouts for about 50 minutes. The Facility did not know how or when C1 left the building. C1 was left without the supervision of a teacher and the facility was unable to maintain visual supervision of the Child.

In the areas that were evaluated, the facility was not in compliance of the California Code of Regulations, Title 22, Division 12. The following citation 101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observationwas issued during today’s inspection on the attached LIC 809D. An immediate civil penalty of $500.00 was assessed today. Upon receiving a Type A violation, the Licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. The facility is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

The Notice of Site Visit was posted. Site Supervisor was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The Site Supervisor was provided a copy of their Appeal Rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. Site Supervisor was informed all appeals must be in writing and received by the Licensing office within 15 business days.
End of Report.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CATALYST KIDS-TURTLE ROCK	FACILITY NUMBER: 300614059
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/22/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 11/01/2021 Section Cited	1 2 3 4 5 6 7	101229 Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child shall be left without the supervision of a teacher at any time,... Supervision shall include visual observation. This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on LPA interviews, Site Supervisor failed to provide care and visual supervision for C1. There was absence of supervision for about 50 mintues, Facility was unaware of his whereabouts. C1 was found to be home after he attended care, Facility was unaware C1 left home. This poses an immediate Health and Safety risk to the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC809 (FAS) - (06/04)

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