343601803-12-13-2022-03-CC-ABLI-CM3TUF-20221213140217

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343601803
Report Date: 12/13/2022
Date Signed: 12/13/2022 02:03:07 PM

Document Has Been Signed on 12/13/2022 02:03 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	CATALYST KIDS - NORTH COUNTRY		FACILITY NUMBER:	343601803
ADMINISTRATOR:	KRYSTLE MITCHELL		FACILITY TYPE:	850
ADDRESS:	3901 LITTLE ROCK DRIVE		TELEPHONE:	(916) 332-5185
CITY:	ANTELOPE	STATE: CA	ZIP CODE:	95843
CAPACITY:	72	CENSUS: 17	DATE:	12/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Krystle Mitchell		TIME COMPLETED:	02:15 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	At approximately 12:30pm on 12/13/22 Licensing Program Analyst (LPA) Amanda Blesi arrived to the facility and met with director Krystle Mitchell to conduct a 1-year required annual inspection. The facility is located on North Country Elementary School grounds in Portables #2, #3 and #4. The facility provides morning and afternoon snacks for the children. Upon arrival, LPA observed 13 napping children in room (full day) and four children in room #2. Five staff were present and one additional staff returned from lunch break around 15 minutes after LPA arrival. LPA toured the facility including all activity/classroom areas, the isolation area, food service area, restrooms, and outdoor play areas. LPA reviewed care and supervision of children, staffing ratios, health related services, furniture, equipment, drinking water, and food service provisions. Catalyst kids has exclusive use of their own playground. LPA reviewed the children's Identification and Emergency Information. LPA reviewed personnel's education and immunization requirements. All staff currently employed with the center have criminal record clearances and are associated to the Sunset Ranch facility #313620604; a waiver is on file. At least one staff member present today has current EMSA approved Pediatric/Child CPR and First Aid. Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: CATALYST KIDS - NORTH COUNTRY	FACILITY NUMBER: 343601803
	VISIT DATE: 12/13/2022

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided an updated Plan of Operation that includes IMS must be submitted to the department. 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
LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing. Director states they have already conducted lead testing for their site.

Title 22 Deficiency has been cited on the attached LIC 809-D. LPA Amanda Blesi informed facility representative Krystle Mitchell that this report dated 12/13/22 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Amanda Blesi informed the facility representative to provide a copy of this licensing report dated 12/13/22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the facility representative, Krystle Mitchell. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/13/2022 02:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: CATALYST KIDS - NORTH COUNTRY	FACILITY NUMBER: 343601803
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on facility walk through, the licensee did not comply with the section cited above when LPA observed the right side cabinet was unlocked under the kitchen sink leaving bleach, and caustic clearing solutions accessible to children in care which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 12/14/2022
	Plan of Correction
1 2 3 4	Director corrected the deficiency immediately by locking the cabinet with a key during today's inspection.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

LIC809 (FAS) - (06/04)

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