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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455920032
Report Date: 08/14/2023
Date Signed: 08/14/2023 12:32:29 PM

Document Has Been Signed on 08/14/2023 12:32 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KINGDOM CAREFACILITY NUMBER:
455920032
ADMINISTRATOR:CAIN, BETTYFACILITY TYPE:
740
ADDRESS:2975 WEST WAYTELEPHONE:
(530) 917-9454
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY: 6CENSUS: 0DATE:
08/14/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Administrator- Desiree WrightTIME COMPLETED:
12:40 PM
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On 08/08/2023, Licensing Program Analysts (LPA's) Jaynae Boyles and Donna Gurriere, arrived at the facility announced to conduct a Pre licensing Inspection. LPA met with Facility Administrator, Desiree Write and explained the purpose of the visit.

LPA Boyles, Gurriere, and Administrator Write toured facility together to ensure that the facility is ready to take its first clients in this. Areas toured include but are not limited to: common areas, backyard and locked shed. LPA observed the facility to be clean, in good repair and odor-free with trash cans.

Component III was conducted during this inspection.

The following items will need to be addressed prior to the facility getting license:

Service for Fire Extinguisher


Locks on outdoor gates removed for fire safety
Lock under the sink to secure chemicals
Laundry room will remain locked
All trash cans need to have a lid
The fireplace shall remain locked and not used, as there is not a screen available.

Several topics were discussed and a copy of the report was left at the facility.

Report completed by Janae Boyles and Donna Gurriere.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2023
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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