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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801692
Report Date: 08/17/2021
Date Signed: 08/17/2021 10:18:17 AM

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:KERNVILLE UNION SCHOOL DISTRICT PRESCHOOLFACILITY NUMBER:
153801692
ADMINISTRATOR:SAMPSON, MARIEFACILITY TYPE:
850
ADDRESS:3240 ERSKINE CREEK ROADTELEPHONE:
(760) 379-5461
CITY:LAKE ISABELLASTATE: CAZIP CODE:
93240
CAPACITY:52CENSUS: 0DATE:
08/17/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Verlona Tate, DirectorTIME COMPLETED:
10:30 AM
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On 08/17/2021, LPA Pete Espinoza conducted a Case Management inspection. LPA met with Verlona Tate, Director. Purpose of inspection was to review and approve use of new classroom for preschool use. There will be no change in capacity. Preschool is adding modular classroom with adequate user space for 26 children. Classroom is located north of existing classroom. Preschool will no longer use classroom #24. LPA observed four toilets and four sinks in restrooms. Preschool will operate with the traditional school year (August - June) Monday - Friday 8:00 AM - 3:00 PM. Breakfast, lunch, and snack will be provided and prepared in the cafeteria on site. There is a sink with hot water inside the classroom to use for food preparation. Ill children and staff will utilize bathroom in the classroom or outside on the premises. Ill children will be isolated in the Director's office. Adequate storage space available for children's belongings. Outdoor storage is available for toys and equipment. Toys and equipment age appropriate and in good repair. There is water available for children with drinking fountains inside and outside.

Director provided updated Personnel Report (LIC 500).

Director will send updated Facility Sketch indicating Classroom 1, Classroom 2 and entire exterior area used by preschool (parking lot, drop-off and play areas).

The classroom addition deemed safe and available for day care use beginning 08/18/2021.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's visit.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021
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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