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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 240403819
Report Date: 10/28/2021
Date Signed: 10/28/2021 10:02:39 AM

Document Has Been Signed on 10/28/2021 10:02 AM - 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:KINGS VIEW WORK EXPERIENCE CENTERFACILITY NUMBER:
240403819
ADMINISTRATOR:KALEMBER, SAMUELFACILITY TYPE:
775
ADDRESS:100 AIRPARK ROADTELEPHONE:
(209) 357-0321
CITY:ATWATERSTATE: CAZIP CODE:
95301
CAPACITY: 200CENSUS: 0DATE:
10/28/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Program Director, Gila OchoaTIME COMPLETED:
10:04 AM
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On 10/28/2021, Licensing Program Analyst (LPA) A. Walton arrived unannounced at the above facility to conduct an Annual Inspection-Infection Control. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Program Director (PD) Gila Ochoa.

LPA conducted a facility tour with PD. There are no clients present during this inspection. Facility staff observed to be wearing facial coverings. Facility offers virtual classes to clients and delivers snacks to clients. Facility is cleaned and sanitized daily. Facility has one central entry and exit. Clients will be in cohorts of 10-12. Clients will be screened prior to entry and escorted to classrooms. Visitors will be screened upon entry. LPA observed signs promoting hand-washing and social distancing. Hand sanitizer is readily available throughout the facility. Bathrooms are stocked with paper towels and liquid soap. LPA observed a 30 day supply of PPE and cleaning supplies. LPA observed the isolation room. Facility will offer cold lunches to clients.

An Annual Continuation Inspection will be conducted at a later date to review resident records.

No deficiencies observed.

An exit interview was conducted with PD As a COVID-19 precautionary measure, a copy of this report will be provided to PD via email and an electronic read receipt confirms receiving this document. Report signed on-site by Facility Representative.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2021
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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