103810101-2-26-2021-04-CC-JMOA-BYLUE3-20210226143026

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810101
Report Date: 02/26/2021
Date Signed: 02/26/2021 02:30:32 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	KINGDOM KIDS ACADEMY AT CLOVIS HILLS		FACILITY NUMBER:	103810101
ADMINISTRATOR:	COLLEEN DAVIS		FACILITY TYPE:	850
ADDRESS:	10590 N. WILLOW AVE		TELEPHONE:	(559) 297-2600
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93619
CAPACITY:	30	CENSUS: 0	DATE:	02/26/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Colleen Davis		TIME COMPLETED:	01:15 PM

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On 02/26/2021, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an announced prelicensing inspection and met with Program Director, Colleen Davis. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located on the premises of Clovis Hills Community Church (CHCC), 10590 N. Willow Ave In Clovis, CA. The applicant, CHCC is requesting a preschool capacity of 60 preschool children. This program will operate on a traditional school year schedule and have an AM session only from 9:00 AM thru 12:00 PM Monday through Friday. This program will operate in the preschool classrooms numbered 206, 207, 212, & 213. The center will provide 1 snack. There is a small kitchen located in classroom 206. There is a children's gate and a door in place so children don't have access to it. Staff will utilize the bathroom located at the entrance of the center labeled as the boys bathroom Since children will use the girls bathroom. Ill children will be isolated in the site supervisors office located in classroom 213 and will use the staff bathroom.

The classrooms had age appropriate toys and were observed to be clean & free of toxins. The cleaning items will be stored in the small kitchen area or in high cabinets inside each classroom. Medication & sharp utensils will be stored in a locked cabinet inside the kitchen area. LPA observed that the furniture and equipment appeared to be safe and in good condition. Colleen will submit proof that there is a working carbon monoxide installed in the center. Colleen stated that she will have a sanitation table outside the center so parents can sign in/out their children. Staff are doing wellness checks & temperature checks every morning during drop off & will have their parents & children wash their hands in the morning using the preschool & staff bathrooms that are located at the front.

Room measurements were taken and reviewed with Colleen. The total inside preschool area measured to an approximate 3,022 square feet which will accommodate the requested preschool capacity. There is adequate storage space available for children's belongings in each classroom.

Report Continued Onto LIC 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KINGDOM KIDS ACADEMY AT CLOVIS HILLS	FACILITY NUMBER: 103810101
	VISIT DATE: 02/26/2021

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Play yard:
· Cover sharp edges on rain gutter.
· Submit Shade structure plans
· Submit water jugs for outdoor play area.

Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 60 preschool children.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure

No deficiencies cited during today's visit.
A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KINGDOM KIDS ACADEMY AT CLOVIS HILLS	FACILITY NUMBER: 103810101
	VISIT DATE: 02/26/2021

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Toys and equipment appeared to be age appropriate. The program will only be a half day program so children will not need cots for napping. LPA observed plenty of tables & chairs. There is a total of 6 toilets and 6 sinks/hand washing fixtures which will accommodate the requested capacity of 60 preschool children. There are water dispensers with disposable cups in each classroom so children can have water readily available to them. Water jugs and disposable cups will be taken out in the play yard as well. There is a water fountain out in the play yard but due to Covid, it’s not going to be used.

The approximate outside square footage for the preschool area is 13,050 square feet which will accommodate the requested capacity of 60 Preschool Children. The preschool play area has a black metal fence that goes all around. LPA observed umbrellas for shade, grass, & plenty of age appropriate toys. There is an age appropriate play structure and wood chips to cushion the fall zones. Colleen stated that the center will install a permanent shade structure in the future, LPA advised Colleen to let licensing know once they do. LPA reminded Colleen to provide adequate supervision at all times.

A fire clearance for 60 preschool children was received and granted by Fresno County Fire Department on 01/06/2021

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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 following items must be completed prior to issuing a license by 03/12/2021.

Inside Daycare:

· Anchor Cubbies
· Submit proof of Carbon Monoxide.
· Check Ceiling Tiles in room 206 next to kitchen
· Get tweezers & Scissors for First Aid Kit
· Submit proof of lock doors leading to room 208 which is not licensed.

Report Continued Onto LIC 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

LIC809 (FAS) - (06/04)

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