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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503808045
Report Date: 06/13/2019
Date Signed: 06/13/2019 03:53:33 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KINGDOM KIDZFACILITY NUMBER:
503808045
ADMINISTRATOR:NUIA, EMILYFACILITY TYPE:
850
ADDRESS:18 SOUTH 6TH STREETTELEPHONE:
(209) 892-5439
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY:56CENSUS: 7DATE:
06/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Brenda MoranTIME COMPLETED:
04:15 PM
NARRATIVE
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An unannounced random inspection #1 is being conducted by LPA Claudia Henley. Met initially with Brenda Moren, Administrator and Stefani Banda, Head Teacher/Interim Director. There were two staff present with 7 children. A tour of facility was conducted inside and outside. Staff were spoken to during visit. The following areas are in compliance during this visit: There are no bodies of water on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. No medication is currently being given at this time. The playground rubber cushioning material under the playground climbing structures is adequate. The concrete slab outside on the playground area near the climbing structures have several large space cracks and pot holes. This could be a potential trip hazard to children. There was adequate amount of shade and water outside. There was a carbon monoxide in one of the rooms which was in working order. Children's toilets, hand washing facilities are sanitary. Fire/disaster drill was conducted in March of 2019. Rooms are safe and clean. Food preparation area is clean, food is protected from contamination. Licensee provides breakfast and snacks only. The children bring in their lunches and there is adequate storage. The facility is in compliance with conditions and limitations specified on the license. Teacher/child ratios are maintained and adequate supervision is being provided during this visit. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility. First aid/CPR reviewed and in compliance. Sign in/sign out sheets were reviewed. Staff and children's files were reviewed. Staff have record of immunization and online child abuse mandated reporter training.

The following is cited per Title 22 Regulations (see page 2). Appeal Rights left with Administrator Brenda Moran.

Site Visit Notice posted. Exit interview was conducted.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KINGDOM KIDZ
FACILITY NUMBER: 503808045
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/12/2019
Section Cited
CCR
101220
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Child Medical Assessment: Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical
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Licensee to obtain the medical assessment and send copy to CCL by 7/12/19
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assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.This requirement was not met as evidenced by: Upon child's file review (Child #1), a medical assessment was not completed.
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Type B
07/12/2019
Section Cited
CCR
101238.2(d)(2)
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101238.2(d)(2) Outdoor Activity Space. Outdoor activity space shall be hazard free. This requirement was not met as evidenced by: LPA observed out on the playground concrete area, there were holes and cracks in the concrete where children play. This is a potential trip hazard for children.
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Licensee to repair the cracks and holes in the concrete. Licensee to send photograph showing repair, along with a work order to CCL by 7/12/19
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
LIC809 (FAS) - (06/04)
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