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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215672
Report Date: 05/31/2024
Date Signed: 05/31/2024 11:08:55 AM

Document Has Been Signed on 05/31/2024 11:08 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CATALYST KIDS- DEL MARFACILITY NUMBER:
566215672
ADMINISTRATOR/
DIRECTOR:		RACHEL CHAMPAGNEFACILITY TYPE:
850
ADDRESS:3150 THAMES RIVER DR.TELEPHONE:
(805) 485-0560
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: DATE:
05/31/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:46 AM
MET WITH:Faviola AmbrizTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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 May 31 2024 at 10:46 AM, Licensing Program Analysts (LPAs) Aaliyah Zendejas and David Roman conducted a case management - incident inspection at the above mentioned Child Care Center (CCC). LPAs met with Faviola Ambriz (S1), staff member at the CCC and explained the purpose of the inspection. S1 stated that the site supervisor was not present today, but that they can assist LPAs for the day. LPA checked designation of responsibility and found the correct form completed for S1. LPAs toured the interior and exterior of the CCC with S1.

LPAs asked S1 about the incident that occurred on 5/21/2024 and if child had returned to care yet. S1 stated that child has returned to care by now, but was out for two days after the incident. S1 stated that right after it occurred, staff texted Child's parent and provided an ice pack immediately. Later by nighttime, child's parent shared that child was dizzy and felt nauseous and was then diagnosed with a concussion. Child was out for two days but is fine now and back in care.

No deficiencies were cited.



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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were given, and report was reviewed with lead teacher, Faviola Ambriz.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Aaliyah Zendejas
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2024
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