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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494249
Report Date: 08/09/2019
Date Signed: 08/09/2019 05:18:56 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KIDS KINGDOMFACILITY NUMBER:
197494249
ADMINISTRATOR:MENDOZA, TRINAFACILITY TYPE:
830
ADDRESS:731 S AVERILL AVETELEPHONE:
(310) 547-4986
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:10CENSUS: 0DATE:
08/09/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Trina Mendoza, ApplicantTIME COMPLETED:
05:20 PM
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On August 09, 2018 at 9:00 AM, Licensing Program Analysts (LPA) Miriam Cohen conducted an announced inspection for a new license upon receiving an application for facility name Kid’s Kingdom 197494249 located at 731 Averill Avenue, San Pedro, CA 90731. The applicant, Trina Mendoza, guided LPA Cohen on a tour of the facility. The indoor areas were observed to be set up for infants.
Per director, wheels shall be placed on two cabinets and one teacher desk for mobility.

There is one infant classroom. The total indoor area accommodates 14 infants.
The total outdoor area for the Infant Program accommodates 12 infants.

There is one separate napping area. LPA observed eight cribs.
LPA observed two portable potty chairs and one portable sink.
This facility has a staff restroom on the premises and an isolation area in the office for sick children.
Fire Clearance was granted on 08/09/19.

The facility was advised to follow the staffing ratio per Title 22 Regulations at all times.

An exit interview was conducted and discussed. A copy of this report was given to Director, Trina Mendoza.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
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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