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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561709864
Report Date: 04/20/2022
Date Signed: 04/20/2022 11:24:23 AM


Document Has Been Signed on 04/20/2022 11:24 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:CATALYST KIDS- GREEN VALLEYFACILITY NUMBER:
561709864
ADMINISTRATOR:RACHEL CHAMPAGNEFACILITY TYPE:
840
ADDRESS:170 NORTH JUANITA AVENUETELEPHONE:
(805) 486-3557
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY:52CENSUS: 0DATE:
04/20/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
10:31 AM
MET WITH:Mandy IzaguirreTIME COMPLETED:
11:40 AM
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On April 20, 2022 at 10:31 AM, Licensing Program Analyst (LPA) Austin Rios conducted an unannounced Case Management – COVID-19 inspection and met with Mandy Izaguirre. LPA informed the purpose for the inspection and completed a COVID-19 pre-screening questions prior to the commencement of the inspection. Director gave LPA a of the facility, inside and outside. There was zero school age children in care at the time of arrival.

This inspection is a follow-up on COVID-19 outbreaks reported by facility staff to CCL between 1/3/2022 and 1/31/2022. CCL provided a Tele - Rapid Assistance Support Team (RAST) inspection where LPA provided COVID-19 resources, current Childcare Industry Guidance, and a COVID-19 self-assessment guide to the facility.
LPA observed facility staff wearing masks upon arrival to the facility. LPA observed mask available for children. LPA observed a sign in sheet outside and Covid-19 posters posted. Facility also conducts temperature checks in the morning upon arrival with all children and staff. LPA observed Covid-19 mitigation plan on file.

LPA discussed facility’s written plan for when a staff member or child tests positive for COVID-19 and developing a written communication plan with parents/guardians to share information and guidelines in their preferred language. LPA discussed COVID-19 Vaccines, Testing, Face coverings, Essential Protective Equipment and Supplies, Physical Distancing, Ventilation, Isolation for Illness, Cleaning and Disinfection, Handwashing, Food Service and Meal Times, How to Respond to Exposures or Outbreaks, and Resilience Tips during the Pandemic.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CATALYST KIDS- GREEN VALLEY
FACILITY NUMBER: 561709864
VISIT DATE: 04/20/2022
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LPA reviewed that facility maintains a current Covid-19 Child Care Program Self-Assessment Guide/Mitigation plan. LPA also provided the following resources:
- Official Public Health and Child Care Guidance for COVID-19 – Updated 1/26/2022.
- COVID-19 Child Care Resources:
https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources

There were no deficiencies cited during today's inspection.

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.


Exit interview conducted and report was reviewed with the Director Mandy Izaguirre.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2