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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846161
Report Date: 07/29/2022
Date Signed: 07/29/2022 10:28:23 AM

Document Has Been Signed on 07/29/2022 10:28 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KIDDIE ACADEMY OF CORONAFACILITY NUMBER:
334846161
ADMINISTRATOR:HERNANDEZ, JAZMINEFACILITY TYPE:
850
ADDRESS:3977 BEDFORD CANYON RDTELEPHONE:
(951) 444-7434
CITY:CORONASTATE: CAZIP CODE:
92883
CAPACITY: 108TOTAL ENROLLED CHILDREN: 108CENSUS: 30DATE:
07/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:36 AM
MET WITH:Payal Kotadiya/OwnerTIME COMPLETED:
11:10 AM
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During the course of a investigation, LPA observed the policy for diaper changing was not followed on 7/11/22. LPA observed the last time the child was changed was 2:49 pm and the sign in-sign out showed 5:23 child was picked up, therefore the diaper was not changed within the 2 hour time frame that is in the facilities policy..


LIC 9102 Advisory Note- Technical Violation was issued.

Director stated they will have a training on the diaper changing policies and submit proof of the topic and a list of participants to CCL by 8/12/22.


Exit Interview conducted with owner, appeal rights and Notice of Site Visit Issued.

Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2022
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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