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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371111
Report Date: 06/25/2024
Date Signed: 06/25/2024 02:10:16 PM

Document Has Been Signed on 06/25/2024 02:10 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CATALYST KIDS-HERITAGEFACILITY NUMBER:
304371111
ADMINISTRATOR/
DIRECTOR:		ORELLANA, CHRISTINAFACILITY TYPE:
840
ADDRESS:15400 LANSDOWNE RDTELEPHONE:
(714) 589-2492
CITY:TUSTINSTATE: CAZIP CODE:
92782
CAPACITY: 140TOTAL ENROLLED CHILDREN: 33CENSUS: 16DATE:
06/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Program Lead-Christina Orellana TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 6/25/2024 at 1:25PM Licensing Program Analyst (LPA) K.Navar conducted an unannounced Case Management Unusual Incident for Catalyst Kids-Heritage at Estock do to Heritage being temporarily closed for summer. Upon arrival, the LPA met with Heritage Program Lead Christina Orellana and discussed the unusual incident that took place on 5/16/2024. The census at the time of the visit was 16 children supervised by 3 staff during unit group.

A review of the Facility Personnel Report Summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption clearance.

The Department received an incident report on 5/16/2024 stating that child was playing on play structure bars during playground time on 5/15/24 and as child was sitting on the bars child fell back hitting the back of head.1 staff witnessed what happened and sent child inside for first aid and called parents.

On 6/25/2024, the LPA interviewed 1 staff (S1). S1 stated that 1 staff (S2) was supervising 12 kids on the playground. S2 approached child when child fell back and sent child in with another staff member to receive first aide. Then staff assessed child’s head inside and got a gauze pad and held it over the area. Staff called parents and let the other staff know what was going on, wrote ouch report, and called Childcare Licensing. Parents came and picked up child.

LPA obtained and reviewed the following documents. A copy of ouch report, photo of playground structure, and roster.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CATALYST KIDS-HERITAGE
FACILITY NUMBER: 304371111
VISIT DATE: 06/25/2024
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Based on the LPA’s observations, interview, and records reviews. Staff witnessed child fallback, provided first aide, called parents, wrote ouch report, called in UIR to childcare licensing. No deficiencies will be cited.

LPA K. Navar conducted an exit interview with Program Lead Chirstina Orellana. Notice of Site Visit was posted during the visit. Program lead was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Program lead was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First-level appeals should be sent to the regional manager to the address listed above.

END.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
LIC809 (FAS) - (06/04)
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