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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370640
Report Date: 07/18/2024
Date Signed: 07/18/2024 02:39:55 PM


Document Has Been Signed on 07/18/2024 02:39 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:CATALYST KIDS-ORCHARD HILLSFACILITY NUMBER:
304370640
ADMINISTRATOR:JUSTIN PUKASAMSOMBUTFACILITY TYPE:
840
ADDRESS:11555 CULVER DRIVETELEPHONE:
(714) 734-3699
CITY:IRVINESTATE: CAZIP CODE:
92602
CAPACITY:105CENSUS: 56DATE:
07/18/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Facility Representative Alicia MendizabalTIME COMPLETED:
02:45 PM
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On 7/18/24, Licensing Program Analyst (LPA), Christine Jung, conducted an onsite inspection for the purpose of an Annual Inspection. Upon arrival at 12:30PM, LPA was led on a tour by facility representative Alicia Mendizabal. The overall census observed was six (6) school age staff and 56 school age children. Facility hours are 7:00AM – 6:00PM, Monday through Friday.

The Facility Personnel Report Summary reviewed on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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.

During the inspection, items which could pose a danger to children (detergents, cleaning compounds, and medications) were not observed to be inaccessible to children. Poisons/Hazardous Items are not kept on the premises. Food is prepared on site; snacks are provided. Food prep areas were clean and sanitary; food was properly stored. Menus were posted where they could be reviewed by authorized representatives. Floors, children’s equipment, and furniture were clean, observed to be in good repair, and free of sharp edges. All storage containers for solid waste, including moveable bins, had tight fitting covers that were kept on and in good repair. There was drinking water available, both indoors and outdoors, to children by refillable bottles labeled with the children’s names. The children's restrooms were clean and sanitary. The facility conducted a lockdown emergency drill on 04/08/24. The facility had a working carbon monoxide detector. Facility met all posting requirements.

Three (3) staff files were reviewed. There was a separate, complete, and current record for each staff.
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SUPERVISOR'S NAME: Martha MalaneTELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Soo Jin JungTELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CATALYST KIDS-ORCHARD HILLS
FACILITY NUMBER: 304370640
VISIT DATE: 07/18/2024
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Six (6) children files were reviewed. There was a separate, complete, and current record for each child. The facility uses a digital app called Hubbe for sign in and out procedure.

The outdoor activity space was inspected for compliance and was enclosed by a fence. The surface of the outdoor activity space was well maintained and free of hazards. The cushioning material made of commercially produced rubber around the climbing equipment, slides, and other similar equipment was sufficient to absorb falls. The outdoor equipment and toys were in good repair. Director stated there are no bodies of water present at the facility.

LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The facility representative was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov Facility representative may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No deficiencies cited.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, Alicia Mendizabal.
SUPERVISOR'S NAME: Martha MalaneTELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Soo Jin JungTELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024
LIC809 (FAS) - (06/04)
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