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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163808460
Report Date: 11/04/2020
Date Signed: 11/04/2020 03:04:01 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:KINGS CHRISTIAN SCHOOL, INC.FACILITY NUMBER:
163808460
ADMINISTRATOR:HARTIG, REBECCAFACILITY TYPE:
850
ADDRESS:900 EAST D STREETTELEPHONE:
(559) 924-8301
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY:45CENSUS: 23DATE:
11/04/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Rebecca HucknallTIME COMPLETED:
02:45 PM
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On this date, 11/4/2020, Licensing Program Analyst (LPA) Ocegueda conducted a unannounced case management tele-inspection. An on site inspection was not able to be conducted due to Covid-19 social distancing restrictions. LPA reviewed the reason for the inspection today, which was to address the unusual incident that was reported to Community Care Licensing (CCL) on 11/2/2020 via telephone regarding child#1 falling inside a classroom.

On 11/2/2020 Director Hucknall, called the Officer of the Day at CCL to report that a child fell over his own feet and was taken to the Emergency Room (ER) by his/her parent. The ER visit indicated a small sprain on his/her right wrist. Present when child fell were two teachers (staff #1 and staff #2) and there were 15 children in care.

Today, 11/4/2020, Director stated that child returned to care on 11/3/2020 without incident and was medically cleared with no play restrictions. During the tele-inspection, LPA inspected the area in preschool classroom #2 where child fell and it was observed that there were no loose objects, toys or lifted carpets. Director stated that the child got up and was observed to have tripped over his/her feet and braced his fall with his right hand.

After reviewing the information with Director Hucknall, it was determined that this was an isolated incident and not a result of lack of supervision. Director reported the incident per the requirement and stated today that the Unusual Incident Report LIC 624 was mailed to the Fresno Regional Office today 11/4/2020.

An exit interview was conducted with Director Hucknall, and she understands that this report will be mailed to the facility and that she will have to sign and return to CCL office.

Per Title 22, Division 12, Chapter 1, no deficiency was cited today.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
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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