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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370115
Report Date: 06/12/2024
Date Signed: 07/08/2024 01:45:03 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/16/2024 and conducted by Evaluator Karen Navar
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240416145416
FACILITY NAME:CATALYST KIDS-HICKS CANYONFACILITY NUMBER:
304370115
ADMINISTRATOR:RAIBON, KRISTENFACILITY TYPE:
840
ADDRESS:3817 VIEW PARKTELEPHONE:
(714) 544-3492
CITY:IRVINESTATE: CAZIP CODE:
92602
CAPACITY:140CENSUS: 0DATE:
06/12/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Site Supervisor-Justin Pukasamsombut TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff cut child's' hair without permission from child's' authorized representative.
Facility staff does not ensure reporting requirements are followed.
INVESTIGATION FINDINGS:
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This report has been amended for report written on 6/12/2024.
On 6/12/24 at 1:45PM, Licensing Program Analyst (LPA), Karen Navar conducted an unannounced complaint inspection for the purpose of delivering findings. This is a continuation of a complaint inspection initiated on 4/23/24.

Upon arrival LPA met with Justin Pukasamsombut at Catalyst Kids Orchard Hills to deliver findings for facility Catlyst Kids Hicks Canyon that is closed for the summer. LPA observed a total of 71 school age children along with 9 staff.

A review of the Facility Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios.
Continue to page 2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 6
Control Number 06-CC-20240416145416
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CATALYST KIDS-HICKS CANYON
FACILITY NUMBER: 304370115
VISIT DATE: 06/12/2024
NARRATIVE
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Page 2
On 04/16/2024, the Orange County Child Care Office received a complaint alleging: Facility staff cut child’s hair without permission from the child’s authorized representative and Facility staff does not ensure reporting requirements are followed.

During the investigation, LPA toured the facility, reviewed documents, and conducted interviews with the reporting party, staff, children, and parents.

On 4/24/2024, Reporting Party (RP) stated facility staff used scissors on the hair of Child 1(C1) without authorized representatives permission and did not report it to the Department of Social Services.

On 4/25/2024, LPA interviewed Staff 1-2 (S1- S2). S1 stated that they were not aware of the scissor and hair incident until about a month prior to investigation and S2 stated they were aware of the incident at the time that it happened.

On 4/25/24, LPA interviewed 3 children. 3 children stated they like coming to school, 3 children stated that they do not get bullied, and 1 of the children interviewed stated that they will go to a teacher if someone bullies them, and the teacher talks to the child.

On 05/07/2024, LPA interviewed Staff 3 (S3). S3 scissors were used on C1s hair, and they did not communicate with management but did communicate with mom on what had happened.

On 4/25/2024, LPA conducted parent interviews. LPA called 8 parents and 4 of the parents called were able to be interviewed. Parents interviewed did not divulge any information pertaining to the allegation.

Based on LPA observations, interviews with reporting party, staff, children, and parents, the preponderance of evidence has been met; therefore, allegations: Facility staff does not ensure reporting requirements are followed. Facility staff cut child’s hair without permission from the child’s authorized representative, which violates the personal rights of C1 and Title 22 reporting requirements is found to be SUBSTANTIATED. See LIC9099D for deficiency cited.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20240416145416
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CATALYST KIDS-HICKS CANYON
FACILITY NUMBER: 304370115
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2024
Section Cited
CCR
101223(a)(1)
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101223 Personal Rights (a) The licensee shall ensure that each child is...(1)To be accorded dignity in his/her personal relationships...
This requirement is not met as evidence by:
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Training with staff regarding childrens personal rights. A copy will be emailed to LPA Navar by 6/21/2024
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Based on LPAs interviews. Facility staff cut child’s hair without permission from the child’s authorized representative,
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Type B
06/21/2024
Section Cited
CCR
101212(d)(1)
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101212 Reporting Requirements(d) Upon the occurrence, during the operation of the child care center...(1)Events reported shall include...
This requirement is not met as evidence by:
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Training with staff regarding reporting requirements. A copy of training will be emailed to LPA Navar by 6/21/2024.
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Based on LPA's interviews. Facility staff cut child's hair without authourized represenatives permsission and did not report it to the Department of Soical Sevices.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/16/2024 and conducted by Evaluator Karen Navar
COMPLAINT CONTROL NUMBER: 06-CC-20240416145416

FACILITY NAME:CATALYST KIDS-HICKS CANYONFACILITY NUMBER:
304370115
ADMINISTRATOR:RAIBON, KRISTENFACILITY TYPE:
840
ADDRESS:3817 VIEW PARKTELEPHONE:
(714) 544-3492
CITY:IRVINESTATE: CAZIP CODE:
92602
CAPACITY:140CENSUS: 0DATE:
06/12/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Site Supervisor-Justin Pukasamsombu TIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
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8
9
Staff does not ensure adequate care and supervision is provided to children in care.
INVESTIGATION FINDINGS:
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On 6/7/2024 Licensing Program Analyst (LPA), Karen Navar conducted an unannounced complaint inspection for the purpose of delivering findings. This is a continuation of a complaint inspection initiated on 4/23/24.

Upon arrival LPA met with Site Supervisor Justin Pukasamsombut at Catalyst Kids Orchard Hills to deliver findings for facility Catalyst Kids-Hicks Canyon that is closed for the summer. LPA observed a total of 71 school age children along with 9 staff.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios.

Continue to page 2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 06-CC-20240416145416
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CATALYST KIDS-HICKS CANYON
FACILITY NUMBER: 304370115
VISIT DATE: 06/12/2024
NARRATIVE
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Page 2
On 04/16/2024, the Orange County Child Care Office received a complaint alleging: Staff does not ensure adequate care and supervision is provided to children in care.

During the investigation, LPA was led on a tour of the facility reviewed documents, conducted interviews with the reporting party, staff, children, and parents.

On 04/24/2024, LPA interviewed RP who stated C1 states that another child has been bullying them. RP stated that staff stated they had not witness anything happen. RP stated that there had been a previous incident with another child that had inappropriately touched child.

On 4/25/2024, LPA was led on a tour. During the visit LPA observed staff supervision in the classroom and on the playground. There were 3 staff and 9 children during LPA’s visit. During classroom observation staff were engaged with children. During playground observation staff were spread out at different points of playground.

On 4/23/2024, LPA interviewed 2 staff (S1- S2). S1 stated when behavior management is needed, they will communicate with parents, observe children, and support children where needed. S1 also stated that there are behavior plans that can be implemented with parent support. S2 stated they will talk to both children to come up with a solution and talk to parents. If more support is needed reaches out to site supervisor. There are behavior plans that can be set up for intervention that are in partnership with the parents. When LPA asked about possible inappropriate touching between children. Staff S1-S2 stated they have not heard of the incident.

On 4/25/24, LPA interviewed 3 children. 3 children stated they like coming to school, 3 children stated that they do not get bullied, and 1 of the children interviewed stated that they will go to a teacher if someone bullies them, and the teacher talks to the child.

On 4/25/2024, LPA conducted parent interviews. LPA called 8 parents and 4 of the parents called were able to be interviewed. Parents interviewed did not divulge any information pertaining to the allegations.

Continue to page 3.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20240416145416
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CATALYST KIDS-HICKS CANYON
FACILITY NUMBER: 304370115
VISIT DATE: 06/12/2024
NARRATIVE
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Page 3
On 5/07/2024, LPA interviewed 1 staff (S3). S3 stated that they manage children’s behavior at the moment it is needed. S3 stated they talk to the children and guide them with whatever support is needed and will talk to parents whether a good day or bad day and if needed will reach out to Site Supervisor. When LPA asked about possible inappropriate touching between children. S3 stated they heard about an incident and was trained in supervision of children.

Based on LPA observations, interviews with reporting party, staff, children and parents, there was not enough evidence to substantiate the allegation: Although the allegation may have happened or is valid the preponderance of evidence has not been met; therefore, the allegation: Facility staff does not ensure adequate care and supervision is provided and is found to be UNSUBSTANTIATED. No deficiency cited.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6