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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620039
Report Date: 02/12/2020
Date Signed: 02/12/2020 10:42:10 AM

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:KINGDOM KIDS CHRISTIAN PRESCHOOLFACILITY NUMBER:
343620039
ADMINISTRATOR:GINA WILMOTFACILITY TYPE:
850
ADDRESS:5810 PECAN AVE.TELEPHONE:
(916) 988-4310
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:46CENSUS: 23DATE:
02/12/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Gina WilmotTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Kelly Ferrara conducted a Plan of Correction inspection at the facility and met with Director Gina Wilmot. During today's inspection, LPA observed 23 children in care supervised by two staff and the Director.

On January 8th, 2020, LPA Ferrara issued the following citation: 101221(a) Incomplete children’s records. During today’s inspection, LPA conducted a children’s file review and observed each child had the required documentation.

LPA was able to clear the citation today and provided a letter as proof.

There were no deficiencies cited based on today's inspection. LPA provided a Notice of Site visit that must remain posted for 30 days for parental review.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020
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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