410517377-6-3-2025-05-CC-MOLN-DHAMVL-20250603095654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410517377
Report Date: 05/21/2025
Date Signed: 06/03/2025 10:17:38 AM

Document Has Been Signed on 06/03/2025 10:17 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CATALYST KIDS - HENRY FORD (SCHOOL AGE)		FACILITY NUMBER:	410517377
ADMINISTRATOR/ DIRECTOR:	BRIANA HUSS/CINDY LIPP		FACILITY TYPE:	840
ADDRESS:	2498 MASSACHUSETTS AVENUE		TELEPHONE:	(650) 368-1138
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY: 70	TOTAL ENROLLED CHILDREN: 56	CENSUS: 46	DATE:	05/21/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:27 PM
MET WITH:	Briana Huss		TIME VISIT/ INSPECTION COMPLETED:	05:15 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	On May 21, 2025, at approx.2:20pm, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Site Supervisor Briana Huss for an unannounced annual random inspection. LPA explained purpose of inspection visit. Present today was site supervisor, 5 staff and 46 school age children. Staff and children capacity ratio requirements were observed to be in compliance today. All staff working at facility have criminal background clearances. Facility operates an after-school program following Redwood City school district schedule. Facility hours of operation are Monday – Friday from 6:30am– 8:15am & 12:30pm- 6:30pm. LPA and site supervisor toured the classrooms for health and safety hazards. Facility operates an after-school program on the campus of Henry Ford Elementary School in portable A & B. Classrooms are clean and orderly and have proper temperature and ventilation. There are plenty of age-appropriate toys/games, art/crafts material, furniture (sofas and tables), and learning materials all in good repair. LPA observed a tank in portable A with a turtle. Flooring in classroom is safe and clean. Storage cubbies are available for children to store personal belongings. Two restrooms are available in portable B and have working toilets and sinks with no running hot water. There are separate restrooms for boys and girls. There is a separate restroom on campus for staff usage. All cleaning products, chemicals and toxins are stored behind locked cabinets and inaccessible to children. There are two outdoor playgrounds: one playground is used for younger children and the other one is used for older children. Playgrounds have age-appropriate climbing/slide play structures. Playground for younger children has an off-limits slide due to a crack, slide is barricaded with a board for inaccessibility to children. LPA observed a cart with outdoor toys for children to use. Playground flooring is grass and asphalt. Flooring underneath play equipment is cushioned with tanbark to absorb falls. LPA observed trees for providing shade to children in care. Playground is fenced off with a 5 ft chain link fence. LPA did not observe any pools, spas, or other bodies of water. Per Site supervisor, there are no weapons or firearms on the premises. Cont. page 2…

Marie Rodriguez	TELEPHONE: (650) 266-8800
Maria Olguin-Leon	TELEPHONE: 650-266-8800
	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALYST KIDS - HENRY FORD (SCHOOL AGE)	FACILITY NUMBER: 410517377
	VISIT DATE: 05/21/2025

NARRATIVE

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Facility provides snacks to children in care, LPA observed monthly menus posted. Children bring their own labeled water bottles from home and are refilled with Brita water pitcher. Kitchenette is in portable A and cabinets are equipped with childproof locks. LPA observed snacks stored properly in cabinets and refrigerator to prevent contamination. First aid kit is fully stocked with medical supplies. Incidental Medical Services were discussed and medication reviewed. Sick children are isolated in office area in portable A and away from other children.

LPA reviewed sign in/sign out on Hubbe app., facility staff use app to sign children into after school program and parents sign children out using a PIN# on Hubbe app. Classrooms have fully charged fire extinguisher. LPA tested smoke detector and carbon monoxide detector, which are in working condition. Facility uses walkie talkies and cell phones to communication with staff and for emergencies.

LPA reviewed 5 children’s records and 5 staff records. Children's and staff records were complete. The facility has all necessary paperwork posted which included: Facility License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. Emergency disaster drill was last conducted on April 9, 2025, and is properly documented. Emergency drills are conducted on a monthly basis.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Cont. page 3…

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALYST KIDS - HENRY FORD (SCHOOL AGE)	FACILITY NUMBER: 410517377
	VISIT DATE: 05/21/2025

NARRATIVE

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Site Supervisor 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Lead testing was completed after due date.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Site supervisor is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Site supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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

Cont. page 4...

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALYST KIDS - HENRY FORD (SCHOOL AGE)	FACILITY NUMBER: 410517377
	VISIT DATE: 05/21/2025

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 26 27 28 29 30 31 32	Page 4... During LPA’s visit no deficiencies were issued in accordance with Title 22 regulations. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements may result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with Site Supervisor, Briana Huss.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC809 (FAS) - (06/04)

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