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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334820505
Report Date: 10/15/2024
Date Signed: 10/15/2024 12:25:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/30/2024 and conducted by Evaluator Courtnee Peebles
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240830105946
FACILITY NAME:CATALYST KIDS - SOUTHSHOREFACILITY NUMBER:
334820505
ADMINISTRATOR:MELISSA GOMEZFACILITY TYPE:
840
ADDRESS:30975 SOUTHSHORE DRIVETELEPHONE:
(951) 679-6401
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY:70CENSUS: 4DATE:
10/15/2024
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Monica MerasTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Day care child sustained an injury while in care.
Facility failed to report incident to parent.
INVESTIGATION FINDINGS:
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On October 15, 2024, at 11:35 AM, Licensing Program Analyst (LPA), Courtnee Peebles arrived unannounced to CATALYST KIDS SOUTHSHORE (CCC) and met with acting director Monica Meras to discuss the above allegations. On October 15, 2024, at 11:40 AM, LPA conducted a tour and census of the CCC. During the investigation, LPA conducted confidential interviews with three staff (D), (S1), (S2) and one witness (P) obtained documents and camera footage pertinent to the investigation.

On August 30, 2024, a complaint was received with allegations stating, day care child sustained an injury while in care and facility failed to report incident to parent. Confidential interviews revealed 4 children enrolled also attend kindergarten at the adjacent elementary school next door to the CCC. CCC staff will walk the enrolled children over to the school and to their respective classrooms when it is time for their class to start. Interviews disclosed C1 arrived on 08/29/2024 at approximately 07:45 AM and played basketball for about 60 minutes outside. Based on the placement of the camera LPA was unable to witness C1 falling or sustaining an injury while playing basketball.
Substantiated
Estimated Days of Completion: 45
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 10-CC-20240830105946
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: CATALYST KIDS - SOUTHSHORE
FACILITY NUMBER: 334820505
VISIT DATE: 10/15/2024
NARRATIVE
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At approximately 10:25 AM C1 and four other students began walking over to the elementary school accompanied by S1 and S4. LPA observed video footage provided by the school district and the video footage shows C1 exiting the gate with what appears to be a “knot” on the right side of their head. C1’s legal guardian recognized the bump during pick up from kindergarten at approximately 02:30 PM and notified both the elementary school and the CCC. Additionally, the facility failed to report the incident to the parent as they were unaware the child had been injured.

Based on confidential interviews, record review and observation the preponderance of evidence standard has been met and the allegations that day care child sustained an injury while in care and facility failed to report the incident to the parent have been made substantiated.

An exit interview was conducted and a copy of this report along with the appeal rights were provided to Acting Director Monica Meras. A notice of site visit was handed to licensee and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20240830105946
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CATALYST KIDS - SOUTHSHORE
FACILITY NUMBER: 334820505
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/15/2024
Section Cited
CCR
101223(a)(b)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:(b) The center shall inform each child's authorized representative of the rights specified in (a) (1) through (8) above.
This requirement is not met as evidenced by:
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 Director will hold a meeting providing all signatures of staff and will put in place health checks upon arrival and departure. Proof will be provided to LPA via email.
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Based on observation and interviews it was determined that C1 sustained an injury that was not known to the staff before walking over to the school. This poses a potential health and safety risk to children in care.
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Request Denied
Type B
11/15/2024
Section Cited
HSC
1012129(f)
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101212 Reporting Requirements (f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative.
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C1's legal guardian was not notified of C1's injury until the end of the day during pick up from kindergarten.
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Based on interviews C1 sustained an injury while in care at the facility. Staff were unable to recall the events of how C1 sustained the injury, therefore C1's legal guardian was not notified by the facility. This poses a health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3