434416999-8-25-2023-07-CC-MSMS-CV2UC2-20230825152715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416999
Report Date: 08/25/2023
Date Signed: 08/25/2023 03:28:18 PM

Document Has Been Signed on 08/25/2023 03:28 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CATALYST KIDS-LAKEWOOD		FACILITY NUMBER:	434416999
ADMINISTRATOR:	KATHY ABADY		FACILITY TYPE:	840
ADDRESS:	750 LAKECHIME DRIVE		TELEPHONE:	(408) 769-4106
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94089
CAPACITY: 70	TOTAL ENROLLED CHILDREN: 16	CENSUS: 13	DATE:	08/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Catelin Khayatan		TIME COMPLETED:	03:40 PM

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	Licensing Program Analysts (LPAs) Mel Matos and Jessica Bongardt met with Catelin Khayatan, Director, for an unannounced Required - 1 Year inspection. LPAs toured the indoor and outdoor areas of the Facility with Catelin during today's inspection. LPAs observed the 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. Days and hours of operation are Monday through Friday 6:30 AM to 6:00 PM. The facility is licensed to serve a maximum of seventy (70) children ages K to 5th grade in Rooms Y1 & Y2. LPAs reviewed five children's and three staff files (1 director & 2 teachers) during today's inspection. Each child's file reviewed contains all required forms/documents, including Admission Agreement, Emergency Medical Consent (LIC 627), and Information and Emergency Information form (LIC 700). All staff files reviewed contain the required forms/documents, including transcripts/verification of experience/immunization records, and Health Screening Report (LIC 503). All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Director & two teachers has current CPR and First Aid certifications on file. Catelin understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). Last fire/disaster drill was completed on May 10, 2023. LPAs observed that the teacher/child ratio was in compliance during today's inspection. LPAs observed thirteen school age children with the director and two teachers during today's inspection. Catelin understands the conditions, limitations, and capacity specifications of the Facility license. Catelin understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director’s office area. LPAs observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Catelin states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Catelin understands that the Facility must be kept free of flies and other insects & rodents. LPAs observed that all furniture and equipment is in good condition and safe for the children. Drinking water is readily available for the children in each Room and in the outdoor playground area via water bottles/water dispensers/disposable cups.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS-LAKEWOOD	FACILITY NUMBER: 434416999
	VISIT DATE: 08/25/2023

NARRATIVE

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Staff and children's bathrooms are clean, sanitary, and operable. Bathrooms for boys and girls are located between Rooms Y1 & Y2. The bathrooms are separate and provide individual privacy. There is a separate staff bathroom stall not utilized by the children which an isolated child can use if needed. Catelin states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in each Room.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility provides breakfast, snacks, and lunch to the children. The Facility has trash cans with tight fitting lids for solid waste in the Facility. Cleaning supplies are inaccessible to the children and stored in locked cabinets inaccessible to children. LPAs observed a complete First Aid kit in the Facility. Catelin states that the Facility does not administer any medication at this time.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

The playground areas utilized by children are surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPAs observed that the outdoor equipment is age appropriate and in good condition. Shade is provided by trees and building overhang in the playground areas. There is sufficient resilient materials (rubber surfacing) in the outdoor playground areas. LPAs did not observe any bodies of water.

Catelin Khayatan, Director, was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

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 interview conducted and report was reviewed with Catelin Khayatan, Director. No deficiencies issued during today's inspection. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
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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