CATALYST KIDS-BESWICK

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 12/15/2025 Licensing Program Analyst (LPA) K. Navar conducted an unannounced Case Management – Incident visit to investigate an unusual incident. Upon arrival, the LPA met with Site Supervisor Yessica Hernandez and informed them of the purpose of the visit. A review of the Facility Personnel Report Summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption clearance. The census at the time of the visit was 0 children and 4 staff present. The Department received a self- reported incident report on 12/05/2025 stating that on 12/04/25 Child #1 (C1) had gone back into the classroom after staff and children had exited out of the classroom to go to the restroom located on Beswick Elementary main campus. On 12/15/2025, the LPA interviewed 2 (two) staff (S1-S2), who were supervising children during the incident that took place on 12/04/2025. 2 (two) staff stated that 18 children and 2 (two) staff were transitioning to the restrooms located on Beswick Elementary main campus and that C1 was left in room 2. All staff interviewed stated that S1 was outside the classrooms and saw C1 in room 2 through the window and immediately went to C1 and took C1 to S2 who was at the restroom area on Beswick Elementary main campus. All staff interviewed stated that children were counted before transitioning out of room 2 and that the classroom door was left open and one light was turned off and one light on and that children were counted at arrival to the restroom located on Beswick Elementary main campus and that S2 then knew C1 was no longer with them and then immediately walkie S1 to inform S1 that C1 was not with them but S1 was walking up to S2 with C1 at that moment. Continue to page 2. NAME OF LICENSING PROGRAM MANAGER: Thuy Ho NAME OF LICENSING PROGRAM ANALYST: Karen Navar LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/15/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2025 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 4 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the

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 12/15/2025 Licensing Program Analyst (LPA) K. Navar conducted an unannounced Case Management – Incident visit to investigate an unusual incident. Upon arrival, the LPA met with Site Supervisor Yessica Hernandez and informed them of the purpose of the visit. A review of the Facility Personnel Report Summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption clearance. The census at the time of the visit was 0 children and 4 staff present. The Department received a self- reported incident report on 12/05/2025 stating that on 12/04/25 Child #1 (C1) had gone back into the classroom after staff and children had exited out of the classroom to go to the restroom located on Beswick Elementary main campus. On 12/15/2025, the LPA interviewed 2 (two) staff (S1-S2), who were supervising children during the incident that took place on 12/04/2025. 2 (two) staff stated that 18 children and 2 (two) staff were transitioning to the restrooms located on Beswick Elementary main campus and that C1 was left in room 2. All staff interviewed stated that S1 was outside the classrooms and saw C1 in room 2 through the window and immediately went to C1 and took C1 to S2 who was at the restroom area on Beswick Elementary main campus. All staff interviewed stated that children were counted before transitioning out of room 2 and that the classroom door was left open and one light was turned off and one light on and that children were counted at arrival to the restroom located on Beswick Elementary main campus and that S2 then knew C1 was no longer with them and then immediately walkie S1 to inform S1 that C1 was not with them but S1 was walking up to S2 with C1 at that moment. Continue to page 2. NAME OF LICENSING PROGRAM MANAGER: Thuy Ho NAME OF LICENSING PROGRAM ANALYST: Karen Navar LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/15/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2025 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 4 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the