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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410517377
Report Date: 01/08/2026
Date Signed: 01/09/2026 08:25:38 AM

Document Has Been Signed on 01/09/2026 08:25 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CATALYST KIDS - HENRY FORD (SCHOOL AGE)FACILITY NUMBER:
410517377
ADMINISTRATOR/
DIRECTOR:		BRIANA HUSS/CINDY LIPPFACILITY TYPE:
840
ADDRESS:2498 MASSACHUSETTS AVENUETELEPHONE:
(650) 368-1138
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 91TOTAL ENROLLED CHILDREN: 91CENSUS: 35DATE:
01/08/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:01 AM
MET WITH:Site Supervisor - Briana HussTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On January 8, 2026, at approximately 2:15 pm, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced case management visit to follow up on an incident that occurred on December 8,2025 and was reported to Regional Office. LPA met with Site Supervisor Briana Huss and explained the purpose of the visit. Present during today's visit was Site Supervisor and 5 staff supervising 35 school age children. All staff present today have criminal background clearances and associated to facility. Facility is operating within staff and child ratios capacity.

The facility operates a before school and after-school program on the campus of Henry Ford Elementary School. Facility is licensed in portable #A & #B and classroom #5. Program operates Monday-Friday from 6:30am-8:15am and 11:00am - 6:00pm.

LPA interviewed Site Supervisor regarding incident, which was self-reported and occurred on December 8, 2025. The incident involved C1 eloping from portable #A and was not followed by S1 or S2 to bring C1 back to facility. C1 was picked up my mom approximately 6-8 minutes later.

During today’s inspection, LPA interviewed Site Supervisor and reviewed staff's written statements, based on the information collected, LPA cited a type B deficiency for lack of supervision, as staff did not maintain direct visual supervision of children at all times.

Per Site Supervisor, staff were interviewed and submitted written statement. S1 and S2 were given a final memorandum of reprimand. Director discussed procedures and policies with staff individually.

See page LIC809D for type B deficiency issued today under CCR, Title 22, Div. 12, Chapt. 1.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview was conducted, and report was reviewed and provided to Site Supervisor, Briana Huss. Appeal rights were provided and explained. Due to technical difficulties report was emailed to facility.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 01/09/2026 08:25 AM - It Cannot Be Edited


Created By: Maria Olguin-Leon On 01/08/2026 at 03:46 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALYST KIDS - HENRY FORD (SCHOOL AGE)
FACILITY NUMBER: 410517377

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/22/2026
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision: (a) "The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation."

This requirement was not met as evidenced by:
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Per Site Supervisor, on January 14, 2026 facility will conduct a staff meeting to discuss protocol and procedures for supervision and elopement of children in care. Site Supervisor conducted a meeting with S1 and S2 and both staff were given a final memorandum of reprimand.

Facility will be installing child safety gates at entrance doors.
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Based on interview and record review, the facility did not comply with the section cited above as facility self-reported an incident where a child eloped from the classroom and staff did not maintain visual supervision, which poses a potential health, safety or personal rights risk to persons in care.
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Site Supervisor will email LPA a copy of meeting agenda with policies and procedures discussed with staff regarding supervision of children. Agenda will include signatures of staff acknowledging attendance and understanding of supervision procedures discussed during meeting..

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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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Maria Olguin-Leon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2026


LIC809 (FAS) - (06/04)
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