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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070206070
Report Date: 02/19/2025
Date Signed: 02/19/2025 03:27:37 PM

Document Has Been Signed on 02/19/2025 03:27 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KING'S VALLEY PRESCHOOLFACILITY NUMBER:
070206070
ADMINISTRATOR/
DIRECTOR:		KETNER, MICHELEFACILITY TYPE:
850
ADDRESS:4255 CLAYTON ROADTELEPHONE:
(925) 687-2020
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 82DATE:
02/19/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:L. SartoriousTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
NARRATIVE
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On 2/19/2025 at 12:35 PM, Licensing Program Analysts (LPAs) Kayla Merchant and Cherie Acosta met with center director L. Sartorius to conduct an unannounced case management visit for a self-reported incident that occurred on 1/23/2025.

C1 was left unsupervised in classroom 9,in the bathroom, during transition from the classroom to the yard. A teacher that was already outside noticed C1 in the classroom alone and yelled to another teacher to retrieve C1 and bring C1 outside to the yard.. C1 was left unsupervised for 10 minutes.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

This is a repeat of a violation that was cited on 9/23/2024 - Responsibility for Providing Care and Supervision 101229(a)(1). Repeat violations are $250 per violation and $100 per day until corrected.

A $250 civil penalty was assessed today. See LIC 809-D for deficiency cited. Notice of site visit was provided and must be posted for 30 consecutive days.

Exit interview conducted with director L. Sartorius.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kayla Merchant
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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Document Has Been Signed on 02/19/2025 03:27 PM - It Cannot Be Edited


Created By: Kayla Merchant On 02/19/2025 at 02:50 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KING'S VALLEY PRESCHOOL
FACILITY NUMBER: 070206070

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/19/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Director should develop a written plan of action to ensure children are not left without supervison at anytime. Director shall submit a copy of this plan to CCL by 2/20/2025. Director stated that she want to participate in TSP.
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This requirement was not met as evidenced by: C1 was left in the classroom unsupervised on 0/23/25 which poses a immediate risk to the health and saftey of children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected.

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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Kayla Merchant
LICENSING EVALUATOR SIGNATURE:
DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2025


LIC809 (FAS) - (06/04)
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