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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270761
Report Date: 08/25/2023
Date Signed: 08/25/2023 12:18:51 PM

Document Has Been Signed on 08/25/2023 12:18 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CATALYST KIDS-LINDBERGHFACILITY NUMBER:
304270761
ADMINISTRATOR:SOTO, GERARDOFACILITY TYPE:
850
ADDRESS:220 23RD STREETTELEPHONE:
(949) 650-2506
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY: 195TOTAL ENROLLED CHILDREN: 195CENSUS: DATE:
08/25/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:TIME COMPLETED:
12:45 PM
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On 08/25/2023 Licensing Program Analyst (LPA) A Bootorabi made an unannounced visit to the facility for a self-reported incident that occurred on 08/23/2023. LPA, Bootorabi was met by the director SOTO, GERARDO. The LPA explained the reason for today's visit.

The census on today’s visit was as follows: Room 10: 13 Students - 2 Teachers / Room 11: 15 Students - 3 Teachers / Room 12: 12 Students 2 Teachers / Room 13: 7 Children - 2 Teachers/ Room 15: 12 Students - 2 Teachers / Room 16: 11 Children - 2 Teacher

The facility representative was reminded 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.

A review of the Facility Personnel Report Summary conducted on 08/25/2023 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 08/23/2023 the facility self reported an incident pertaining to personal rights. LPA interviewed on 8/25/2023 1 Staff, and 5 children. LPA reviewed 4 staff files, and 1 childs files.

Further investigation is needed at this time
A child's file was reviewed during today's inspection and was not complete. A consultation was provided for children's file. Resource provided for self assessment of children files, and forms and records to maintain in facility.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CATALYST KIDS-LINDBERGH
FACILITY NUMBER: 304270761
VISIT DATE: 08/25/2023
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An exit interview was conducted, and the report was reviewed with the director, SOTO, GERARDO . Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023
LIC809 (FAS) - (06/04)
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