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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370213
Report Date: 09/14/2022
Date Signed: 09/14/2022 12:05:45 PM

Document Has Been Signed on 09/14/2022 12:05 PM - 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CATALYST KIDS-TRIDENTFACILITY NUMBER:
304370213
ADMINISTRATOR:PHILLIPS, DEBBIEFACILITY TYPE:
850
ADDRESS:1800 WEST BALL ROADTELEPHONE:
(714) 999-5632
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 41TOTAL ENROLLED CHILDREN: 41CENSUS: 7DATE:
09/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Debbie Phillips, DirectorTIME COMPLETED:
10:30 AM
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Licensing Program Analyst, Patricia Rivas conducted an unannounced Case Management visit for the purpose to discuss the Lead Sampling Testing conducted on 08/24/2022.
This facility consists of rooms 21 and 22.

LPA was informed that each time a new Lead Sampling Testing is conducted the company relabels the outlets. The outlet labeled as A on the August 24th report was the outlet labeled originally as E then changed to C. The Department cited for the ALE when outlet was labeled as E. The outlets have been made inaccessible . No more re tests will be conducted..

Ms. Phillips reports that since beginning of COVID In 2020 the facility has stopped using faucets for drinking water used bottles of drinking water and also had been using paper plates, portable, sinks for hand washing and using water from outlets that have passed lead test for cleaning.

The facility has been previously cited and as part of plan of correct Outlet E/C and now labeled as A has been inoperable. Faucet was originally changed and now handles have been removed making the outlet inoperable.

Ms. Phillips reports outlet is not necessary since there are sufficient sinks and faucets in room.. There are two working faucets.

Exit interview conducted and report was reviewed with the facility representative, Debbie Phillips A notice of site visit was given and must remain posted for 30 days.
Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2022
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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