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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810079
Report Date: 03/01/2022
Date Signed: 03/01/2022 03:40:28 PM

Document Has Been Signed on 03/01/2022 03:40 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KING'S CORNER CHILDCARE, LLCFACILITY NUMBER:
103810079
ADMINISTRATOR:DIANA MEJIAFACILITY TYPE:
830
ADDRESS:1080 N CHESTNUT AVETELEPHONE:
(559) 374-8577
CITY:FRESNOSTATE: CAZIP CODE:
93702
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: DATE:
03/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Diana MejiaTIME COMPLETED:
04:00 PM
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On 03/01/2022 Licensing Program Analyst (LPA) Nancy Her, conducted an unannounced Annual Required Inspection for the infant license. LPA met with Director Diana Mejia and Assistant Director Lindsi Pipkin, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 6:00 am to 6:00 pm.

There is an in-ground swimming pool that is empty inside the building. Swimming pool is enclosed completely by walls and all entrances to the swimming pool is locked with deadbolts. Swimming pool area is used as a storage area. Swimming pool is not used for infants. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is not maintained in a safe condition and is not free of hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. There is a working carbon monoxide detector.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Continued on 809-C
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: KING'S CORNER CHILDCARE, LLC
FACILITY NUMBER: 103810079
VISIT DATE: 03/01/2022
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Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than four infants in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child, medical assessment, individual feeding plan, and Infant Needs and Services Plan. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. Staff records do not contain documentation of meeting qualification requirements. Menus are posted at least one week in advance where an authorized representative can view them. The facility has sufficient age appropriate furniture, and equipment including cribs, cots or mats, changing tables and feeding chairs. There is indoor and outdoor activity space for infants that is physically separate.

Each crib, mat or cot is occupied by only one infant at time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib. Infants are not swaddled while in care. Staff physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Documentation for infants up to 12 months includes sleeping position if it is other than on their back. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Staff-infant ratio requirements are being met while infants are sleeping. LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Continued on 809-C
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
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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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: KING'S CORNER CHILDCARE, LLC
FACILITY NUMBER: 103810079
VISIT DATE: 03/01/2022
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights.

Exit interview conducted and report was reviewed with the facility representative Lindsi Pipkin.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
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Document Has Been Signed on 03/01/2022 03:40 PM - It Cannot Be Edited


Created By: Nancy Her On 03/01/2022 at 02:58 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KING'S CORNER CHILDCARE, LLC
FACILITY NUMBER: 103810079

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. The outdoor activity space has an area that is not level, has holes, and is not free of hazards which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/18/2022
Plan of Correction
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Licensee will make area inaccessible to infants. Licensee will have area fixed and submit photos to Fresno Community Care Licensing by 3/18/2022.
Type B
Section Cited
CCR
101429(a)(2)(B)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Licensee was unaware staff are to check on sleeping infants under 24 months of age and keep documention of every 15 minute check which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/18/2022
Plan of Correction
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Licensee will physically check on sleeping infants every 15 minutes and keep documentation on safe sleep log. Licensee will submit copy of safe sleep log showing two weeks of documentation to Fresno Community Care Licensing by 03/18/2022.
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:Duane Matsubara
LICENSING EVALUATOR NAME:Nancy Her
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2022


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