304270758-5-19-2021-06-CC-KDEI-C36TTD-20210519150033

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270758
Report Date: 05/19/2021
Date Signed: 05/19/2021 03:00:44 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-TRIDENT		FACILITY NUMBER:	304270758
ADMINISTRATOR:	PHILLIPS, DEBBIE		FACILITY TYPE:	830
ADDRESS:	1800 WEST BALL ROAD		TELEPHONE:	(714) 999-5632
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	30	CENSUS: 5	DATE:	05/19/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Director Ms. Phillips Debbie and Ms. Saneto Ann		TIME COMPLETED:	03:15 PM

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Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced Case Management Licensee initiated inspection for removing one infant room # 22, without a change of capacity (30), at the above facility.
Facility Director Ms. Phillips, Debbie gave a tour of the new current classrooms (Room # 23 and 24)

On today's inspection the capacity for Infant capacity remains at 30 and facility shall continue to use the previously licensed rooms (23 and 24).

Indoor Measurements:

Room # 24 Infant (front area)	9.08	13.42	121.85		121.85
Room # 24 Infant (back area)	29.42	19.42	667.39		667.39
Room # 23	27.08	18.42	498.81	207.39	291.42

Total indoor space: 1080.67 divided by 35 = 30.88 (31 Infants)

The indoor activity space for infants is physically separate from other component, it is equipped with appropriate furniture and equipment including the cribs, changing table and toys. The furniture was in good repair in safe was age appropriate for infants to access and move around safely.
Toys were safe and washed with a safe disinfectant
Napping area was observed to have individual cribs, each crib had bedding with tight fitted sheets which are changed daily, there is a safe walkway in-between the cribs allowing staff to reach each infant without stepping or reaching over.
Center policy is all the infant needs are provided to the Infants including Diapers and Formula

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2021

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-TRIDENT	FACILITY NUMBER: 304270758
	VISIT DATE: 05/19/2021

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Infant changing table was observed to have padded surface covered with washable vinyl, with raided sides and sink was within arm’s reach.
Infant food area was clean, bottles, dishes and food containers brought from home were labeled with the infant’s name / date. Age appropriate seating equipment is used during feeding time.
Needs and Service plan is updated quarterly or as needed, there is ongoing communication with the parents via an electronic application daily.
Parents sign in manually at the entrance of the facility.

Outdoor yard was observed to have safe age appropriate toys, the small play equipment’s are placed on a soft mat to absorb any falls. It was fenced and shaded.
There is waiver in place for staggered schedule

Based on today’s room measurement, Facility has enough Indoor space to support 30 Infants (6 weeks to 24 months) in Room # 23 and 24. Monday to Friday 7.30 AM to 5.00PM.

After a tour of the center, An Advisory note was issued to the facility Director.

Web address for downloading forms or regulations was provided as (http://ccld.ca.gov/PG411.htm).

Exit interview conducted. Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post it will result in civil penalties of $100.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2021

LIC809 (FAS) - (06/04)

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