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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561709946
Report Date: 11/06/2020
Date Signed: 11/06/2020 09:45:37 AM

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- MOUNDFACILITY NUMBER:
561709946
ADMINISTRATOR:DEBORAH DORFMANFACILITY TYPE:
840
ADDRESS:455 S. HILL RD.TELEPHONE:
(805) 650-8791
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:79CENSUS: 0DATE:
11/06/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Robin O'TooleTIME COMPLETED:
09:45 AM
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On November 6, 2020 at 9:01 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an announced Case Management inspection. Due to the COVID - 19 and Department of Public Health guidelines of social distancing, a tele-inspection was conducted. LPA met with Director Robin O'Toole and discussed the nature and purpose of the inspection. The tele-inspection was conducted via Facetime. During this tele-inspection the Director took LPA on a tour of the facility. There was no children in care at the time of the inspection. Children are currently doing distant learning until the room has been authorized to be used.

Facility submitted application to Community Care Licensing requesting to add an extra classroom to their license. On October 7, 2020 the Ventura City Fire Department inspector conducted a fire inspection. The facility received a fire clearance approval for the additional classroom. The facility plans to use the classroom to meet the needs of the children and to follow COVID-19 guidelines. The extra classroom has it's own restroom with a single toilet and sink readily available for children to use. Director advised they plan have no more than 23 children at a time in the classroom.

Classroom Measurements:
Classroom - 908.5 square feet meets and exceeds the requirements for 23 children.

Facility additional room use is effective today, November 6, 2020.

A copy of this report was reviewed and provided to Director O'Toole. Director agreed to receive a copy of report via email and voiced understanding that the delivery receipt confirmation from email will be in lieu of their signature once she received the report. LPA requested Director to send a copy of signed document for records.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2020
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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