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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845644
Report Date: 04/21/2022
Date Signed: 04/21/2022 02:50:03 PM

Document Has Been Signed on 04/21/2022 02:50 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINGSTON ACADEMYFACILITY NUMBER:
334845644
ADMINISTRATOR:KAREN BRAZZILLFACILITY TYPE:
850
ADDRESS:6048 ETIWANDA AVENUETELEPHONE:
(951) 681-4182
CITY:MIRA LOMASTATE: CAZIP CODE:
91752
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 0DATE:
04/21/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Hanbo Liang/Karen Brazzill/Dylan McKelroyTIME COMPLETED:
02:45 PM
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On 04/21/2022, at time listed above, an informal conference was held at the Riverside Regional Office. Present in the conference were Licensee Hanbo Liang, Director Karen Brazzill, Assistant Director Dylan McKelroy, Licensing Program Manager (LPM) Gilbert Sena and Licensing Program Analyst (LPA) Justin Giese.

The Purpose of the meeting is to review and discuss the following:
  • Responsibility for Providing Care and Supervision
  • Director Qualifications and Duties

Facility's compliance history was reviewed during this conference. During this conference, LPM and LPA introduced the Child Care Technical Support Program (TSP) and informed Licensee, Director and Assistant Director that TSP is a voluntarily program to assist facilities with meeting and maintaining the requirements of operating a licensed child care facility. Director agreed to submit a written update on whether the facility will voluntarily participate in TSP.

During today's conference, the following regulations and documents were discussed and provided to Director/Licensee.101215: Administrator Qualifications and Duties, 101215.1: Child Care Center Directors Qualifications and Duties, 101229: Responsibility for Providing Care and Supervision and (PIN) 22-12-CCP Child Care Licensing Webinars

Continued on LIC809C
Gilbert Sena
Justin Giese
DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINGSTON ACADEMY
FACILITY NUMBER: 334845644
VISIT DATE: 04/21/2022
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Director/Licensee was advised to visit the Department's website at: https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers on a regular basis for licensing updates. Director/Licensee was advised to review Child Care Provider videos related to “Supervising Children in A Child Care Centers” and "What is a Civil Penalty?” Child Care Center Operators video website link was provided during this conferencehttps://ccld.childcarevideos.org/child-care-center-operators/

Additionally, LPA Giese informed the Licensee and Facility Director to provide a copy of this licensing report dated 04/21/2022 to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISOR'S NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022
LIC809 (FAS) - (06/04)
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