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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 310318500
Report Date: 02/27/2020
Date Signed: 02/27/2020 03:16:04 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:KINGS BEACH STATE PRESCHOOLFACILITY NUMBER:
310318500
ADMINISTRATOR:HILL, HILLARYFACILITY TYPE:
850
ADDRESS:8125 STEELHEADTELEPHONE:
(530) 582-3740
CITY:KINGS BEACHSTATE: CAZIP CODE:
96143
CAPACITY:32CENSUS: 13DATE:
02/27/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Hillary Hill - DirectorTIME COMPLETED:
03:30 PM
NARRATIVE
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Please Note: All times noted in the report are an approximation.
On Thursday, February 27th, 2020, at 1:57pm, Licensing Program Analyst (LPA) Blake Morillas met with the Director, Hillary Hill, for the purpose of an unannounced Annual/Random inspection. At 1:54pm,13 preschool age children and 3 staff were observed.

Operating hours for the 2019-2020 school year are 8:30am to 3:00pm, Monday through Friday. The facility is closed during the Summer with the last day of School being June 11th, 2020.

At 1:50pm, LPA initiated a health and safety inspection of all indoor areas accessible to children.

LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Snacks are prepared inside the classroom with Lunch being provided and prepared by the elementary school the program shares a campus with. LPA inspected the snack area inside the classroom and observed that the food products appeared to be protected against contamination. Menus were posted. LPA reviewed care and supervision of children, staffing ratios, health related services (including medications and first aid supplies), furniture, equipment, and fire drills logs. LPA observed all required forms to be posted. Sign/in-sign/out sheet were reviewed. Drinking water is readily accessible to children in care. LPA observed sinks and toilets to be operable. There are adequate toys, equipment, and supplies available for the children.

At 2:15pm, LPA inspected the outdoor play area and observed adequate cushioning material and play equipment to be in safe condition. Shaded areas are also available. Water jugs and cups are used for drinking water when outside.

*Continued on LIC 809-C
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: KINGS BEACH STATE PRESCHOOL
FACILITY NUMBER: 310318500
VISIT DATE: 02/27/2020
NARRATIVE
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*Continuation of LIC 809

At 2:24pm, LPA began to review children’s and staff's files. The director verbally confirmed that all staff currently employed with the facility have criminal record clearances, health screening reports with TB test, immunizations, and Mandated Reporter training. At least one staff member present today has current Pediatric CPR and First Aid.

LPA provided and discussed the Safe Sleep in Child Care and Lead Testing brochures (AB 2370).

LPA provided the Licensing Agency website (ccld.ca.gov), so the Director may obtain updated licensing information, regulations, and forms.

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated 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 for TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the Americans with Disabilities Act, available at: http://www.ada.gov/childqanda.htm

In the areas that were evaluated, there were no deficiencies at this time.

At 3:04pm, LPA reviewed the report with the Director and an exit interview was conducted.

LPA provided a Notice of Site Visit and the Director acknowledges that this notice shall remain posted for 30 days for parental review.



The Director's signature on this form acknowledges receipt of this form.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020
LIC809 (FAS) - (06/04)
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