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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561709946
Report Date: 01/21/2025
Date Signed: 01/21/2025 03:30:03 PM

Document Has Been Signed on 01/21/2025 03:30 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CATALYST KIDS- MOUNDFACILITY NUMBER:
561709946
ADMINISTRATOR/
DIRECTOR:		DEBORAH DORFMANFACILITY TYPE:
840
ADDRESS:455 S. HILL RD.TELEPHONE:
(805) 650-8791
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 79TOTAL ENROLLED CHILDREN: 79CENSUS: 18DATE:
01/21/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:16 PM
MET WITH:Kalee PizaroTIME VISIT/
INSPECTION COMPLETED:
02:17 PM
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On 1/21/2025 ,Licensing Program Analysts (LPA) German Negrete conducted an unannounced Annual/required inspection of the above mentioned School Age Program (Facility). LPA met with Kalee Pizaro, site supervisor of the Facility. LPA explained the purpose and nature of the inspection. The program operates Monday – Friday 7AM to 6PM. Currently the facility uses two rooms for child care services. At the time of inspection, LPA observed 18 children and 4 staff providing care and supervision. The site supervisor assisting with the care and supervision of children when required.

LPA observed required licensing documents mounted on the wall at the entrance of the facility. Last fire and disaster drill was conducted on 10/17/2024. Each of the classrooms have age-appropriate toys and furniture readily accessible for children in care. A menu is also posted in a visible location. The Facility's children Sign In/Out forms were reviewed by LPA. The forms contained the arrival and departure times of children in care and well as the signatures of the children's authorized representatives. The classrooms of the Facility are clean and orderly. The Facility's has one carbon monoxide detectors and multiple smoke detectors. LPA tested Carbon Monoxide detector at 1:43PM and observed operable. LPA could not test smoke detectors due to the alarms being connected to one system. Site Supervisor stated the smoke detector was tested at the beginning of the month.



The Facility uses two restrooms for children. All restrooms are in sanitary condition. Site supervisor states the children are not monitored by Facility staff when using the restrooms. LPA observed a operable refrigerator in the classroom. If required, the refrigerator is used for food. Incidental medical services is stored in a locked boxed inside a cabinet, a inaccessible area. The Facility provides snack and breakfast to children once a day. Lunch is not provided to children in care at this Facility. The Facility also has available filtered drinking water for children inside the classroom. Facility's constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for (Continued on LIC809-C)
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CATALYST KIDS- MOUND
FACILITY NUMBER: 561709946
VISIT DATE: 01/21/2025
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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 in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Facility tested lead in the appropriate time frame as outlined in Title 22.

Disinfectants, cleaning solutions and sharps are observed in locations accessible to staff members but not accessible to children in care.

The Facility outdoor playground areas are enclosed by fencing. The fence’s entry/exit gates are secured. The surfaces of the outdoor playground areas are varied. The play equipment is free of sharp, loose or pointed objects. The play structures in the outdoor playground areas have adequate cushioning materials to absorb falls. No bodies of water are observed on site.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information, among other required licensing documentation and forms. Staff records were reviewed. LPA reviewed Mandated Reporter training certifications for staff and found Mandated Reporter Training certification is up to date . Site supervisor was reminded to ensure training certification are kept current. Site Supervisor r notes no firearms or ammunition are stored on site.

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-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers,
as specified in HSC 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. (CONT. LIC809-C)
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CATALYST KIDS- MOUND
FACILITY NUMBER: 561709946
VISIT DATE: 01/21/2025
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Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was read/reviewed to site supervisor.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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