<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334820506
Report Date: 11/05/2024
Date Signed: 11/05/2024 01:50:11 PM

Document Has Been Signed on 11/05/2024 01:50 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CATALYST KIDS - CALLIE KIRKPATRICKFACILITY NUMBER:
334820506
ADMINISTRATOR/
DIRECTOR:
AMERICA ANGELESFACILITY TYPE:
840
ADDRESS:28800 REVIERE DRIVETELEPHONE:
(951) 723-8861
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 7DATE:
11/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:31 PM
MET WITH:America AngelesTIME VISIT/
INSPECTION COMPLETED:
02:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On November 5,2024 at 01:31 PM Licensing Program Analyst’s (LPA’S) Courtnee Peebles arrived unannounced at CATALYST KIDS- CALLIE KIRKPATRICK (CCC) to conduct a case management visit. On 10/17/2024 CCLD received an unusual incident report stating Child 1 (C1) sustained a broken collar bone while at the CCC while playing tag with another child enrolled at the CCC. Facility records were reviewed, and Director (D) was interviewed. LPA toured the facility to observe the area in which the incident occurred and based on information gathered, the facility acted appropriately, and no violations have been identified.

Based on interviews, C1 and another child were playing tag outside when C2 tagged C1 and accidentally pushed C1 causing C1 to fall between the grass and the dirt with S1 supervising them. S1 immediately went into the kitchen to grab ice when C1's legal guardian arrived to pick C1 up. S1 stated, they informed C1's guardian of the incident and C1 and their guardian proceeded home. Later that night the Assistant director received a text message asking when C1 fell due to their collar bone still aching. AD stated, they informed C1's guardian the incident occurred during pickup. The following day the CCC staff were notified that C1 had broken their collar bone original and C1 was in a sling. At a later follow up appointment C1 was removed from the sling stating C1 in fact did not have a broken collar bone just extremely bruised. In addition, the facility’s staff reported the incident timely to the Department.

An exit interview was conducted and copy of this report was provided to Owner, America Angeles.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1