434400281-11-21-2024-07-CC-GKUN-DCKP6L-20250103100228

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434400281
Report Date: 11/21/2024
Date Signed: 11/21/2024 11:04:21 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/04/2024 and conducted by Evaluator Liridon Fici

COMPLAINT CONTROL NUMBER: 07-CC-20241004094323

FACILITY NAME:	CATALYST KIDS - EL TORO		FACILITY NUMBER:	434400281
ADMINISTRATOR:	JULIZA PONCE		FACILITY TYPE:	850
ADDRESS:	455 EAST MAIN STREET		TELEPHONE:	(408) 778-1402
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY:	32	CENSUS: 10	DATE:	11/21/2024
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	JULIZA PONCE		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff did not provide adequate supervision resulting in child sustaining multiple bruises.

INVESTIGATION FINDINGS:

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On 11/21/2024, at 8:50 AM, Licensing Program Analyst (LPA) Liridon, Doni Fici arrived unannounced to conduct a complaint investigation and was greeted by Director, JULIZA PONCE, and explained the purpose of the visit.

During the course of the investigation, LPA interviewed two (2) staff, and parents and obtained the following documents: Incident report (September 2024), and Emergency contact information.

Continue on Lic9099-C...

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Liridon Fici	TELEPHONE: 408-598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 07-CC-20241004094323

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS - EL TORO	FACILITY NUMBER: 434400281
	VISIT DATE: 11/21/2024

NARRATIVE

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It was alleged that; Staff did not provide adequate supervision resulting in child sustaining multiple bruises. Based on interviews with staff, and parents, it was stated that on the morning of 9/26/2024, C2 pushed C1 resulting in bruises on the side of the child’s body. Parent stated C1 would get scared and shake when C1 would see C2 during preschool because she was worried, she will get hurt by C2; Parent stated C1 would sometimes hide behind the parent to ensure her safety. S2 informed S1 about the incident that occurred on 9/26/2024. S1 generated an incident report on 9/26/2024 and was submitted to CCL.

Based on interviews, record review, and evidence gathered during the investigation process, the Department concludes that "Staff did not provide adequate supervision resulting in child sustaining multiple bruises", The above allegation is thus found to be SUBSTANTIATED, meaning the allegation is valid because the preponderance of the evidence standard has been met.

The following type B deficiency was cited on the attached page (9099-D). Licensee was informed that failure to correct the deficiency by the specified Plan of Correction (POC) Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted with Director, and a copy of this report reviewed and provided alone with appeal rights.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Liridon Fici	TELEPHONE: 408-598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

LIC9099 (FAS) - (06/04)

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Control Number 07-CC-20241004094323

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS - EL TORO	FACILITY NUMBER: 434400281
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/21/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed Type B 11/28/2024 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	101223(a)(1)- Personal Rights: (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director is currently working with C2's parents and with the child by using a token board when C2 is being good and C2 will get a positive aknowledgment. Director stated the center is currently working with the Board Certified Behavior Analyst (BCBA) to help give tool to support C2 with his behavior; this process is on-going.
	8 9 10 11 12 13 14	Based on Interview and record review, the licensee did not comply with the section cited above by not keeping C1 safe in preschool resulting in bruises from another child, which poses a potential health, safety, or personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Liridon Fici	TELEPHONE: 408-598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

LIC9099 (FAS) - (06/04)

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