CATALYST KIDS - PLEASANT GROVE

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On June 7, 2024 Licensing Program Analyst (LPA) Jennie Tedlos met with Director (D1), Jennifer Tydingco to follow up on an Unusual Incident Report (UIR) submitted to Community Care Licensing on 5/30/24. Present were 6 children in care and 2 staff. LPA conducted interviews during today's visit. On 5/22/24, an incident occurred where a staff member (S1) witnessed another staff member (S2) pour water over the head of a Child (C1) during water play without permission. The same day, S1 observed S2 use a personal water bottle to pour water on C1's head again without permission. S1 observed that C1 was upset and crying during both incidents. S1 reported the incident to Director (D1), Jennifer Tydingco on 5/24 when both S1 and D1 were present at the facility. After D1 was notified, the facility conducted an internal investigation and placed S2 on administrative leave and is being terminated as of today. D1 has stated to LPA that staff has since been retrained on reporting incidents to administration, mandated reporter duties, child rights, and strategies to create a safe environment for the children in care. A deficiency is being cited based on LPA observation, and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. A Type A violation regarding Personal Rights is hereby assessed. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files. An exit interview was conducted and Plans of Correction were reviewed and developed with the Director. A copy of this report and appeal rights were discussed and left with Director. A notice of site visit was provided and posted by LPA and must remain posted for 30 days. * This is an amended version of a report originally signed on 6/7/24. LPA mistakenly recorded the report's "Type of Visit" as "Annual/Random" instead of "Case Management -Incident". SUPERVISORS NAME: Karyn Guerra LICENSING EVALUATOR NAME: Jennie Tedlos LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024 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 2 FACILITY NAME: CATALYST KIDS - PLEASANT GROVE FACILITY NUMBER: 343621304 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/07/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 06/10/2024 Section Cited CCR 101223(a)(3) 1 2 3 4 5 6 7101223 Personal Rights: (a) The licensee shall ensure that each child is accorded ...personal rights:...(3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature ...1 2 3 4 5 6 7The facility launched an internal investigation following the incident and has placed Staff 2 on administrative leave and will be terminated as of today. Staff trainings were conducted including the following topics: mandated reporter duties, child rights, and reporting incidents. The facility's staff will watch the... 8 9 10 11 12 13 14This regulation was not met as evidenced by: LPA learned that S2 poured water over the head of C1 twice in one day without permission from C1. Both times C1 was observed to be upset and crying.This poses an immediate risk to the health and safety of children in care.8 9 10 11 12 13 14CDSS Community Care Licensing training video on personal rights. D1 will send LPA signatures from staff stating that they watched and understand the training video by the POC due date, 6/10/24.* This is an amended version of a report from 6/7/24. Report recorded as "Annual/Random" instead of "Case Management-Incident". 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME:Karyn Guerra LICENSING EVALUATOR NAME:Jennie Tedlos LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024

Type A citation - immediate risk to health, safety, or personal rights

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On June 7, 2024 Licensing Program Analyst (LPA) Jennie Tedlos met with Director (D1), Jennifer Tydingco to follow up on an Unusual Incident Report (UIR) submitted to Community Care Licensing on 5/30/24. Present were 6 children in care and 2 staff. LPA conducted interviews during today's visit. On 5/22/24, an incident occurred where a staff member (S1) witnessed another staff member (S2) pour water over the head of a Child (C1) during water play without permission. The same day, S1 observed S2 use a personal water bottle to pour water on C1's head again without permission. S1 observed that C1 was upset and crying during both incidents. S1 reported the incident to Director (D1), Jennifer Tydingco on 5/24 when both S1 and D1 were present at the facility. After D1 was notified, the facility conducted an internal investigation and placed S2 on administrative leave and is being terminated as of today. D1 has stated to LPA that staff has since been retrained on reporting incidents to administration, mandated reporter duties, child rights, and strategies to create a safe environment for the children in care. A deficiency is being cited based on LPA observation, and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. A Type A violation regarding Personal Rights is hereby assessed. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files. An exit interview was conducted and Plans of Correction were reviewed and developed with the Director. A copy of this report and appeal rights were discussed and left with Director. A notice of site visit was provided and posted by LPA and must remain posted for 30 days. * This is an amended version of a report originally signed on 6/7/24. LPA mistakenly recorded the report's "Type of Visit" as "Annual/Random" instead of "Case Management -Incident". SUPERVISORS NAME: Karyn Guerra LICENSING EVALUATOR NAME: Jennie Tedlos LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024 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 2 FACILITY NAME: CATALYST KIDS - PLEASANT GROVE FACILITY NUMBER: 343621304 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/07/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 06/10/2024 Section Cited CCR 101223(a)(3) 1 2 3 4 5 6 7101223 Personal Rights: (a) The licensee shall ensure that each child is accorded ...personal rights:...(3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature ...1 2 3 4 5 6 7The facility launched an internal investigation following the incident and has placed Staff 2 on administrative leave and will be terminated as of today. Staff trainings were conducted including the following topics: mandated reporter duties, child rights, and reporting incidents. The facility's staff will watch the... 8 9 10 11 12 13 14This regulation was not met as evidenced by: LPA learned that S2 poured water over the head of C1 twice in one day without permission from C1. Both times C1 was observed to be upset and crying.This poses an immediate risk to the health and safety of children in care.8 9 10 11 12 13 14CDSS Community Care Licensing training video on personal rights. D1 will send LPA signatures from staff stating that they watched and understand the training video by the POC due date, 6/10/24.* This is an amended version of a report from 6/7/24. Report recorded as "Annual/Random" instead of "Case Management-Incident". 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME:Karyn Guerra LICENSING EVALUATOR NAME:Jennie Tedlos LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024