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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434403618
Report Date: 01/31/2024
Date Signed: 01/31/2024 04:35:33 PM


Document Has Been Signed on 01/31/2024 04:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:KINGDOM KREWFACILITY NUMBER:
434403618
ADMINISTRATOR:VALORIE WILLIAMSFACILITY TYPE:
840
ADDRESS:1730 CURTNER AVENUETELEPHONE:
(408) 264-2811
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY:116CENSUS: 40DATE:
01/31/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:17 PM
MET WITH:Valorie Williams TIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Program Director, Valorie Williams, for an unannounced Required- 3 Year Inspection. LPA was granted access to the facility by Valorie and toured both indoors and outdoors during the inspection. Upon arrival, there were twenty-seven (27) school-age children and two (2) staff members present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation for the facility are Monday – Friday, 7:00AM-6:00PM.

LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. The last fire/disaster drill was conducted on 12/12/2023, which is compliant with the six-month requirement for facilities. LPA observed two fully charged 2A10BC fire extinguishers (last serviced: 7/2023) and functioning carbon monoxide detector. The facility has a built in fire detection system that is checked annually. The Director states that she currently has children in care who require Incidental Medical Services (EpiPen) and administers medication at this time. LPA observed that medication is properly stored out of reach of children, with the proper documentation. LPA reminded to monitor expiration dates of medication and to obtain medication in the original packaging. There are no weapons or firearms on the premises.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINGDOM KREW
FACILITY NUMBER: 434403618
VISIT DATE: 01/31/2024
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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. Room 7 is overflow for the homework room, Room 8 is the play room, Room 9 is the homework room, Room 10 is parent sign-out/library, Room 11 is not currently in use, Room 12 is the playroom, and Room 14 is also not currently in use. During today's inspection, the children were observed in the sanctuary watching a movie due to the rainy conditions outside. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. The floors were clean and free of tripping hazards. Drinking water is readily available for children in the facility via drinking fountains. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary. There is a working telephone in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (tanbark) to absorb falls. The outside area has a playground, basketball courts, hockey nets, large grass field, and turf area. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by building overhang and large trees.

The facility offers a half day program and provides snack to the children. LPA observed that the snack menu is in writing and posted at least one week in advance, accessible to authorized representatives. Portion sizes for the snack menu will be posted. Equipment necessary for the storage, preparation and service of food is well maintained, clean, and sanitized after each use.

Five (5) children’s files and four (4) staff files were reviewed and all required documents were present. There is at least one staff member present with current CPR/First-Aid that expires 11/2024. The Program Director has current Mandated Reporter Training that expires on 10/31/2025. LPA reminded that the Mandated Reporter Training must be renewed by all staff every 2 years.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINGDOM KREW
FACILITY NUMBER: 434403618
VISIT DATE: 01/31/2024
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The Program Director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded that there shall be at least one person with valid CPR and First-Aid certifications on site at all times or present during off site activities, such as field trips. The facility transports children and LPA observed that all drivers have a valid California drivers license. Children are transported from St Christopher's, Booksin Elementary School, and Schallenberger Elementary School. The Director states that this varies each year depending on the enrollment of children into the program.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. The facility completed water lead testing with CA Rural Water Association on 9/11/2023 and no Action Level Exceedances were found.

Exit interview conducted and report was reviewed with the Program Director, Valorie Williams.

As a result of today’s inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

LPA requested the facility submit the following documents for updated:

-Application for a Child Care Center (LIC200A)
-Administrative Organization (LIC309)
-Board Resolution indicating Jessica Camp as Preschool Director
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC809 (FAS) - (06/04)
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