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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500314924
Report Date: 06/09/2022
Date Signed: 06/09/2022 01:29:38 PM


Document Has Been Signed on 06/09/2022 01:29 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:KIDDIE KINGDOMFACILITY NUMBER:
500314924
ADMINISTRATOR:CASTILLO, DAISYFACILITY TYPE:
850
ADDRESS:3900 MORGAN ROAD, SUITE GTELEPHONE:
(209) 537-8944
CITY:CERESSTATE: CAZIP CODE:
95307
CAPACITY:70CENSUS: 40DATE:
06/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Daisy CastilloTIME COMPLETED:
12:45 PM
NARRATIVE
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On 06/09/2022, Licensing Program Analysts (LPAs) Jeovanna Yanez and Araceli Gibson conducted an unannounced case management inspection. LPAs met with Director, Daisy Castillo, who accompanied LPAs on a tour of the facility, and a census was taken. The purpose of today’s inspection is to address a lead exceedance referred to as an Action Level Exceedance (ALE) of over 5 parts per billion (ppb) from water at the facility.

On 06/02/2022, Fresno Regional Office (FRO) received notification that a water outlet at the facility has very high lead exceedance from the water sample collected on 10/28/2021. Director provided LPAs a copy of LIC 9275 External Water Sampler Self-Certification Form, LIC 999 Facility Sketch, and LIC 9276 Child Care Center Sampling Checklist Form. LPAs reviewed the facility sketch with Director to identify which water outlets tested with ALE. Director stated the kitchen sink is the only water outlet to have high lead exceedance. Director stated the kitchen sink is only used for rinsing dishes and washing staff hands. Children do not have access to the kitchen sink, nor do they drink water from the kitchen sink. Director stated children get alternative portable drinking water from filtered water that is purchased from local water dispensers. LPAs informed Director that the facility needed a waiver and provided her directions on how to request a waiver. LPAs observed Director make the water outlets inoperable by covering with faucet with duct tape. LPAs discussed with Director different options to bring the facility into compliance: removing and replacing the water outlet, and requesting a waiver to provide alternate potable water like bottled water. LPAs also discussed grant funding available for testing and remediation of lead in Child Care Centers.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D). Director was provided a copy of appeal rights. An exit interview was conducted with the Director.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Jeovanna YanezTELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
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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Document Has Been Signed on 06/09/2022 01:29 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: KIDDIE KINGDOM
FACILITY NUMBER: 500314924

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/24/2022
Section Cited

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Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced based on interview and record review. A water outlet at the facility has
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very high lead exceedance. This is a potential risk to the health, safety, and/or personal rights of children in care.
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Director agrees to update Plan of Operation to include corrections made for addressing the lead exceedance. Director stated she will conduct a follow up water sample as outlined in Written Directives section 101705 and submit all required documentation to CCL by 6/24/22.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Jeovanna YanezTELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2022
LIC809 (FAS) - (06/04)
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