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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709504
Report Date: 01/02/2024
Date Signed: 01/02/2024 05:21:28 PM

Document Has Been Signed on 01/02/2024 05:21 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CATALYST KIDS - LOS ALAMITOSFACILITY NUMBER:
430709504
ADMINISTRATOR:CARRIE SMITHFACILITY TYPE:
840
ADDRESS:6130 SILBERMAN DRIVETELEPHONE:
4082686331
CITY:SAN JOSESTATE: CAZIP CODE:
95120
CAPACITY: 105TOTAL ENROLLED CHILDREN: 105CENSUS: 19DATE:
01/02/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Carrie SmithTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) , Sheena Chin, conducted an unannounced Required - 3 year inspection of the school-age center. LPA met with the director, Carrie Smith, and explained the purpose of the visit. The Facility is licensed to serve age TK to 5th grade in room E – 6 (room 1) for TK to Kindergarten and E – 13 (room 2 & 3) for 1 to th grade. The facility opens before the Los Alamitos elementary school starts and after the elementary school ends. Hours of operation: 6:30am to 8:05am and 2:07pm to 6pm Monday to Friday. The director stated that the facility is serving winter camp in the E - 13 room only because the Los Alamitos elementary school locked the Room E - 6. The operation hour for winter camp is from 7am to 6pm. The director sated that during regular school hours the facility orders from local grocery store for breakfast and one snack but now, during winter camp the facility also provides lunch other than breakfast and one snack. The director stated that the facility does not have weapons on the premises, that smoking is not allowed on the premises and that the facility administers Epi-pen for one kid in Room E - 6 when needed.

Observation
LPA toured the indoor and outdoor areas of the Facility.
Required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule were observed.

The facility has fully charged Fire Extinguishers, functioning smoke/carbon monoxide detectors, First Aid Kit, central heating, and air conditioning. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Restrooms for children to use were observed to be in operating condition. Play equipment were maintained in a good condition, free of hazards.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CATALYST KIDS - LOS ALAMITOS
FACILITY NUMBER: 430709504
VISIT DATE: 01/02/2024
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Observation
The food storage areas were clean, free of litter, rubbish, and rodents/vermin. Foods and beverages were kept protected against contamination and spoilage. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Trash cans for solid waste had tight-fitting covers on.

The teacher/child ratio was in compliance during today's inspection. 12 children from TK to 2nd grade with two teachers in Room 2, and 7 children from 3rd to 5th grade with one teacher in Room 3. The director stated that she understands the conditions, limitations, and capacity specifications of the Facility license and that children shall be always supervised within the classroom and in the playground areas.
The facility uses the playground in the elementary school. Shade is provided by trees and building overhangs in the playground area. The outdoor equipment is age-appropriate and in good condition. There is a climbing structure in the playground that is age appropriate. Rubber surfacing is used as resilient material throughout the playground. Areas around and under high climbing equipment were cushioned with material that absorbs falls. There were no bodies of water observed.

Records review
Disaster drills shall be conducted at least every six months and be maintained for at least one year. The last drills were conducted on 1 / 26 / 23.
LPA reviewed facility's sign in/out procedure and record. The facility uses an app for parents to sign in and out. Staff signs children in after the elementary school ends and parents sign children out during pick-ups. A sampling of children and staff files was selected for review. Children records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Medical Assessment. Staff records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. LPA advised the director that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA' inspection.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CATALYST KIDS - LOS ALAMITOS
FACILITY NUMBER: 430709504
VISIT DATE: 01/02/2024
NARRATIVE
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Records review
LPA advised the director that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Discussion
Water lead test: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed on 2/7/22 accordance to the Written Directives outlined in PIN 21-21.1.CCP. LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

Incidental Medical Services (IMS): This facility provides Incidental Medical Services – IMS and per the site director, one child in Room – 6 needs Epi-pen when needed. Room – 6 was locked due to winter break. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CATALYST KIDS - LOS ALAMITOS
FACILITY NUMBER: 430709504
VISIT DATE: 01/02/2024
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Deficiency
Regulatory violations were observed during the inspection. Citations were issued.

Further questions
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit
Notice of Site Visit was given and must remain posted for 30 days.
Exit interview was conducted. This report, the citation, plan of correction, and appeal rights were reviewed and discussed with Licensee, Carrie Smith.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/02/2024 05:21 PM - It Cannot Be Edited


Created By: Sheena Chin On 01/02/2024 at 12:36 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS - LOS ALAMITOS
FACILITY NUMBER: 430709504

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. The facility does not condcut fire drill every 6 months, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/08/2024
Plan of Correction
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The director will send a copy of the fire drill to LPA.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. One of the staff did not have current mandated reporter training certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/08/2024
Plan of Correction
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The director will send a copy of the mandated reporter training certificate to LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Sheena Chin
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2024


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