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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270879
Report Date: 04/14/2021
Date Signed: 04/14/2021 03:43:41 PM

Document Has Been Signed on 04/14/2021 03:43 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CATALYST KIDS-NEWPORT HEIGHTSFACILITY NUMBER:
304270879
ADMINISTRATOR:LEE, SION GLORIAFACILITY TYPE:
840
ADDRESS:300 E. 15TH STREETTELEPHONE:
(949) 574-1411
CITY:NEWPORT BEACHSTATE: CAZIP CODE:
92663
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 15DATE:
04/14/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Director Gloria LeeTIME COMPLETED:
03:40 PM
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Tele- Inspection Case Management Visit due to COVID-19 State of Emergency

Licensing Program Analyst (LPA) Odom conducted a case management inspection in response to a self-reported incident. LPA Odom notified Director that due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing a Tele-Inspection would be conducted.

A Tele-inspection via Facetime was made with Director Gloria Lee. A tour of the facility was conducted via Facetime. LPA took census, there were 15 school age children present, 7 school age children with 2 staff in Room 1 and 8 school age children with 2 staff in Room 2. A review of the Facility Personnel Report Summary on 04/14/2021 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 04/01/2021 an self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that on 03/29/2021 during distance learning Staff asked child why they were late to class, child stated, staff did not admit child into the session on time. Staff told child “you lied to me” and child started to cry. During today’s visit, LPA obtained an updated copy of the LIC9040 Children’s Roster, and interviewed Director. Due to insufficient information available at this time, the reported incident needs further investigation.
An exit interview was conducted with Director, Gloria Lee, via tele-inspection on this date. Appeal Rights were reviewed and explained. A copy of this report and Appeal Rights (LIC 9058 1/16) where emailed to the Director. First level appeals should be sent to the Regional Manager to the address listed above. The Director will email a received acknowledgement as her signature for this report due to the tele-inspection delivery by typing, “I have read and received the Report, I acknowledge receipt” in the subject line of the return email.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2021
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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