CATALYST KIDS - ZEHNDER RANCH

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Corina Beckby met with Program Lead, Lisa McClelland to follow up on the Unusual Incident Report (UIR) submitted to Community Care Licensing on 10/07/24. The center self-reported that on 09/30/24, a child was tapped on the head with a spongy ball by Staff#1 as a form of discipline. LPA conducted interviews with staff and children. The information obtained corroborated the incident as reported to the Department. Staff#1 no longer works for Catalyst Kids. A Type B deficiency was cited on the subsequent page (809-D) of this report. Facility evaluation report was reviewed and discussed with licensee. Exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Bettina Engelman LICENSING EVALUATOR NAME: Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024 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 - ZEHNDER RANCH FACILITY NUMBER: 343621948 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/01/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/02/2024 Section Cited CCR 101223(a)(3) 1 2 3 4 5 6 7The licensee shall ensure that each child is accorded the following personal rights: …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… This requirement was not met as evidenced by:1 2 3 4 5 6 7Director will conduct training with staff regarding Personal Rights, watch dept video on PR and have staff sign statement saying they 8 9 10 11 12 13 14Based on interview, the facility did not comply with the section cited above, in that a staff member intentionally tapped a child with a spongy ball on the head, which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14understand, respect and honor children’s PR. 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:Bettina Engelman LICENSING EVALUATOR NAME:Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024

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

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Corina Beckby met with Program Lead, Lisa McClelland to follow up on the Unusual Incident Report (UIR) submitted to Community Care Licensing on 10/07/24. The center self-reported that on 09/30/24, a child was tapped on the head with a spongy ball by Staff#1 as a form of discipline. LPA conducted interviews with staff and children. The information obtained corroborated the incident as reported to the Department. Staff#1 no longer works for Catalyst Kids. A Type B deficiency was cited on the subsequent page (809-D) of this report. Facility evaluation report was reviewed and discussed with licensee. Exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Bettina Engelman LICENSING EVALUATOR NAME: Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024 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 - ZEHNDER RANCH FACILITY NUMBER: 343621948 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/01/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/02/2024 Section Cited CCR 101223(a)(3) 1 2 3 4 5 6 7The licensee shall ensure that each child is accorded the following personal rights: …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… This requirement was not met as evidenced by:1 2 3 4 5 6 7Director will conduct training with staff regarding Personal Rights, watch dept video on PR and have staff sign statement saying they 8 9 10 11 12 13 14Based on interview, the facility did not comply with the section cited above, in that a staff member intentionally tapped a child with a spongy ball on the head, which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14understand, respect and honor children’s PR. 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:Bettina Engelman LICENSING EVALUATOR NAME:Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Corina Beckby met with Program Lead, Lisa McClelland to follow up on the Unusual Incident Report (UIR) submitted to Community Care Licensing on 10/07/24. The center self-reported that on 09/30/24, a child was tapped on the head with a spongy ball by Staff#1 as a form of discipline. LPA conducted interviews with staff and children. The information obtained corroborated the incident as reported to the Department. Staff#1 no longer works for Catalyst Kids. A Type B deficiency was cited on the subsequent page (809-D) of this report. Facility evaluation report was reviewed and discussed with licensee. Exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Bettina Engelman LICENSING EVALUATOR NAME: Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024 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 - ZEHNDER RANCH FACILITY NUMBER: 343621948 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/01/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/02/2024 Section Cited CCR 101223(a)(3) 1 2 3 4 5 6 7The licensee shall ensure that each child is accorded the following personal rights: …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… This requirement was not met as evidenced by:1 2 3 4 5 6 7Director will conduct training with staff regarding Personal Rights, watch dept video on PR and have staff sign statement saying they 8 9 10 11 12 13 14Based on interview, the facility did not comply with the section cited above, in that a staff member intentionally tapped a child with a spongy ball on the head, which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14understand, respect and honor children’s PR. 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:Bettina Engelman LICENSING EVALUATOR NAME:Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Corina Beckby met with Program Lead, Lisa McClelland to follow up on the Unusual Incident Report (UIR) submitted to Community Care Licensing on 10/07/24. The center self-reported that on 09/30/24, a child was tapped on the head with a spongy ball by Staff#1 as a form of discipline. LPA conducted interviews with staff and children. The information obtained corroborated the incident as reported to the Department. Staff#1 no longer works for Catalyst Kids. A Type B deficiency was cited on the subsequent page (809-D) of this report. Facility evaluation report was reviewed and discussed with licensee. Exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Bettina Engelman LICENSING EVALUATOR NAME: Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024 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 - ZEHNDER RANCH FACILITY NUMBER: 343621948 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/01/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 12/02/2024 Section Cited CCR 101223(a)(3) 1 2 3 4 5 6 7The licensee shall ensure that each child is accorded the following personal rights: …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… This requirement was not met as evidenced by:1 2 3 4 5 6 7Director will conduct training with staff regarding Personal Rights, watch dept video on PR and have staff sign statement saying they 8 9 10 11 12 13 14Based on interview, the facility did not comply with the section cited above, in that a staff member intentionally tapped a child with a spongy ball on the head, which poses a potential health, safety or personal rights risk to persons in care.8 9 10 11 12 13 14understand, respect and honor children’s PR. 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:Bettina Engelman LICENSING EVALUATOR NAME:Corina Beckby LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024