1997, 08-27 Day Care Licensing by DSHSSTATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
P.O. Box 2538, B32-21 • Spokane, Washington 99220-4038
August 27, 1997
Lucenette Hicks, Director
KID CITY PRESCHOOL AND DAY CARE
5920 East 9th Avenue
Spokane, WA 99212
Dear Ms. Hicks: .
Under the authority granted to the Washington State Department of Social
and Health Services, by Chapter 74.15 Revised Code of Washington (RCW) and
RCW 74.08.044, this office is issuing a full day care center for children license to
the above named facility.
The license is for the care of up to 42 boys and girls between the ages of
one month and 12 years of age inclusive. The license is for the period from
September 1, 1995 through August 31, 1998.
The premises licensed for use under this license are the buildings and the
adjoining grounds under your control.
Your license is being issued based on the following information:
A report was received August 11, 1995 from the Office of the State Fire
Marshal approving the facility for licensing.
The attached license shall be posted in a conspicuous place in the facility.
Violation of the conditions of the license may be cause for action to modify"or
terminate the license.
Your license is being issued based on the following information:
Lucenette Hicks
August 27, 1997
page 2
A report was received from the Department of Health Services April 21,
1997 with reported deficiencies which you agreed to correct. A final report was
received July 14, 1997, acknowledging your progress letter dated May 21, 1997
and stating the agency is certified.
Linda S. Ernst, the licensing specialist, visited August 26, 1997 and
reports all deficiencies have been corrected.
The staff names on the application have been cleared.
Continuing supervision of the facility operation by representatives of the
Department or State Fire Marshal is required by law. Consultation is available by
request to Linda S. Ernst, your assigned licensing specialist. You may write or
call this office at (509)456-4017.
• Please notify Linda S. Ernst of any changes in staff, program or other
changes, as required by WAC 388-150-490. Information about your facility will
be entered in regional and state .ide directories of licensed facilities. If you
employ a new supervisor, please submit references, resume and transcripts as
soon as possible.
Sincerely,
—1/<;-
Tim Nelso , Regional Manager
Office of Child Care Policy
Region 1
TN:LSE:lrb
Encl.
cc: Department of Health
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAP C-38, 832-2I • Spokane, Washington 992204038
SECOND INITIAL LICENSE
March 1, 1996
Lucenette Hicks, Director
KID CITY DAY CARE
5920 East 9th Avenue
Spokane, WA 99212
Dear Ms. Hicks:
Under the authority granted to the Washington State Department
of Social and Health Services, by Chapter 74.15 Revised Code of
Washington (RCW) and RCW 74.08.044, this office is issuing a second
six month Initial day care center for children license to the above
named facility.
The license is for the care of up to 21 boys and girls between
the ages of one month and 12 years of age inclusive_ The license is
for the period from March 1, 1996 through August 31, 1996.
The premises licensed for use under this license are the
buildings and the adjoining grounds under your control.
The attached license shall be posted in a conspicuous place in
the facility. Violation of the conditions of the license may be
cause for action to modify or terminate the license.
Your license is being issued based on the following
information:
A report was received August 11, 1995 from the Office of the
State Fire Marshal approving the facility for licensing.
A report was received from the Department of Health Services
August 9, 1995 with reported deficiencies which you agreed to
correct. A final report was received October 6, 1995 acknowledging
your progress letter dated September 20, 1995, and stating the
agency is certified.
Lucenette Hicks
March 1, 1996
page 2
Linda S. Ernst, the licensing specialist for your area,
visited the facility February 26, 1996, and reports the following
deficiencies to be corrected under the Second Initial License.
1. Still need personnel policy,
2. Play ground fence, and
2. other items not completed on Form 10-141.
The staff names on the application have been cleared.
Three positive character reference letters on behalf of
Lucenette Hicks are required before a.full license will be issued.
Continuing supervision of the facility operation by
representatives of the Department or State Fire Marshal is required
by law. Consultation is available by request to Linda Ernst,your
assigned licensing specialist. You may write or call this office at
456-4017.
Please notify Linda Ernst of any changes in staff, program or
other changes, as required by WAC 388-150-490. Information about
your facility will be entered in regional and statewide directories
of licensed facilities. If you employ a new supervisor, please
submit references, resume and transcripts as soon as possible.
Sincerely,
Tim Nelson, Regional Manager
Office of Child Care Policy
Region 1
TN:LSE:lrb
Encl.
cc: Joe Gallegos, Advisory Sanitarian, Health Services
Fern Bettridge, Health Licensing Program Manager ET-33
STATE OF WASI IINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAF C-38, R32-21 • Spokane, Washington 99220-4038
PROVISIONAL LICENSE
September 12, 1995
Lucenette Hicks, Director
KID CITY DAYCARE
5920 East 9th Avenue
Spokane, WA 99212
Dear Ms. Hicks:
CERTIFIED MAIL
Under the authority granted to the Washington State Department
of Social and Health Services, by Chapter 74.15 Revised Code of
Washington (RCW) and RCW 74.08.044, this office is issuing a six
month provisional day care center for children license to the above
named facility.
The license is for the care of up to 21 boys and girls between
the ages of one month and 12 years of age inclusive. The license is
for the period from September 1, 1995 through February 29, 1996.
The premises licensed for use under this license are the
buildings and the adjoining grounds under your control.
A provisional license, rather than a full 3 year license, is
being issued at this time in order to provide additional time for
you to correct the deficiencies noted and for you to work out any
initial operational problems you may encounter.
Since granting a provisional license, instead of a full
license, I must inform you of the right to contest this decision in
an adjudicative proceeding (Administrative Hearing). An application
for an adjudicative proceeding must be in writing, state the basis
for contesting this decision, include a copy of this decision, be
received at the Department's Office of Appeals within 28 days of
the manner that shows proof of receipt. You can file an application
by certified mail addressed to:
Chief, Office of Appeals
P.O. Box 2465
Olympia, Washington 98504
Lucenette Hicks
September 12, 1995
page 2
Should you decide not to contest this decision to grant a
provisional license, the provisional license will remain in effect
until the date noted on it.
The attached license shall be posted in a conspicuous place in
the facility. Violation of the conditions of the license may be
cause for action to modify or terminate the license.
Your license is being issued based on the following
information:
A report was received September 5, 1995 from the Office of the
State Fire Marshal approving the facility for licensing.
A report was received from the Department of Health Services
August 8, 1995, certifying compliance with all health protection
requirements that could be assessed prior to operation under a
provisional license.
Laura Dallison, the licensing specialist for your area,
visited the facility August 17, 1995, and reports deficiencies
which are to be corrected under the provisional license. You
received a listof these deficiencies on August 17, 1995.
Continuing supervision of the facility operation by
representatives of the Department or State Fire Marshal is required
by law. Consultation is available by request to Laura Dallison,
your assigned licensing specialist. You may write or call this
office at 458-2174.
Please notify Laura Dallison of any changes in staff, program
or other changes, as required by WAC 388-150-490. Information about
your facility will be entered in regional and statewide directories
of licensed facilities.
Sincerely,
Nels , Regional Manager
Office of Child Care Policy
Region 1
TN:LD:lrb
Encl.
cc: Joe Gallegos, Advisory Sanitarian, Health Services
Fern Bettridge, Health Licensing Program Manager ET-33
'e
Washington State
OP
rSOCAL[&HE�A7L H
11 SERVICES
OFFICE OF CHILD CARE POLICY (OCCP)
FULL CHILD DAY CARE CENTER LICENSE
PROVIOERNUMBER (IFANY)
In compliance with and pursuant to the laws of the State of Washington in meeting health standards and the minimum
licensing requirements of the Department of Social and Health Services, a full license is hereby granted to
KID CITY PRESCHOOL AND DAYCARE
to conduct and maintain at
city of SPOKANE
5920 East 9th Avenue
for the care of children between the ages of
42 children.
Limitations:
county of SPOKANE:
One Month and -12 Years
, State of Washington;';
, inclusive;cliut not to exceed
This license shall be in force from the_ 1ST day of
SEPTEMBER
to and including the 31 ST day of AUGUST
Dated at SPOKANE
Washington, this 27th
OCCP LICENSOR
inda S. Ernst
( 509 ) 456-4017
TELEPHONE NUMBER
, 1998 , subject to revocation for due -cause:
P R OIONA • • WAGER
Tim Nelstn
( 509 ) 456-3925
TELEPHONE NUMBER
to
NOTE: This
catiion above decribed. Issuedand Is by Authority of Chapter 7for use 4.15aRevisedual or Code of Washington.
it 'Is issued and at the
OS11S 10-218(X) (04/96)
597286
Il717
OFFICE OF CHILD CARE POLICY (OCCP)
FOURTH INITIAL CHILD DAY CARE CENTER LICENSE
PROVIDER NUMBER (IF ANY)
In compliance with and pursuant to the laws of the State of Washington in meeting health standards and the minimum
licensing requirements of the Department of Social and Health Services, an initial license is hereby granted to
KID CITY DAY CARE
to conduct and maintain a child day care center at
city of Spokane
for the care of children between the ages of
21
children.
county of
1 month
5920 East 9th Avenue
Spokane , State of Washington,
and 12 years
, inclusive, but not to exceed
Limitations, if any:
This license shall be in force from the
3rd day of
to and including the 2nd day of September
Dated at Spokane
Washington, this 24th
5
OCCPLICENSORLICENSOR
inda S. Ernst
509 )_ 456-4017
TELEPHONE NUMBER
March , 1997
19,97 , subject to revocation for due cause.
day of February
, 1997
OCCP REGIONALTFANAGER
Tim Nelson
( 509 ) 456-3925
TELEPHONE NUMBER
NOTE: This license is not transferable, and Is valid only for use by the individual or agency to whom it Is issued and at the
location above decribed. Issued by Authority of Chapter 74.15 Revised Code of Washington.
DSHS i0-2 i8A(X) (omve)
597286
�Washingfon State
7r
OFFICE OF CHILD CARE POLICY (OCCP)
THIRD INITIAL CHILD DAY CARE CENTER LICENSE
PROVIDER NUMBER (IF ANY)
In compliance with and pursuant to the laws of the State of Washington in meeting health standards and the minimum
licensing requirements of the Department of Social and Health Services, an initial license is hereby granted to
KID CTTY TRAY CARE
to conduct and maintain a child day care center at 5920 East 9th Ave.
city of Spokane county of Spokane , State of Washington,
for the care of children between the ages of 1 mo.
21 children.
Limitations, if any:
and 12yrs. , inclusive, but not to exceed
This license shall be in force from the 1st day of
to and including the 2nd
Dated at
day of March
Spnkne Washington, this
S Cti—.r
OCCP LICENSOR
Linda Ernst
(__509_)456. 4.0.17_
TELEPHONE NUMBER
NOTE: This license is not transferable, and is valid only
location above decribed. Issued by Authority of
• Sepfemm r 199R
, 1997 , subject to revocation for due cause.
19th day of August 1996
Ixi
COP REGIONAL MANAGER
Tim Nelson
(_ 5.0.ff__)_456
TELEPHONE NUMBER
for use by the Individual or agency to whom it is issued and at the
Chapter 74.15 Revised Code of Washington.
•
OSH$ 1O-210A0)(04/96)
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DEPARTMENT Oh' SOCIAL AND HEALTH SERVICES
ebttbren'Zgerncp itcern5e
The Secretary of the Department of Social and Health Services Does Certify:
That a license is hereby granted to _
KID CITY DAY CARE
597286
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to conduct and maintain at 5920 East 9th Avenue
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city of Spokane , county of.. Spokane .. , State of Washington. E3
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A DAY CARE CENTER FOR CHILDREN
a) for the care of children, Male and Female sex, between the ages of 1 month and 12..years .__, x
Gminclusive, but not to exceed 21 children; (c24*1)
osi
in the State of Washington in compliance with and pursuant to the laws of the State of Wash-
ington and the Rules and Regulations of the State Department of Social and Health Services.
IA
i This license shall be in force from the 1 S.t....................clay of.... March, 1996,
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ril to and including the...._...3.1st__ day of.... August.. , 12.96., subject to revocation for due cause,
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DATED AT Spokane WASHINGTON, THIS
per5 'CCe (t) (Rev i i.ed
Center Director or Designee
Tim Nelson', Regional Manager
NOTE: This license is not transferable: and is valid only for use by the individual or agency to whom It is issued and at the location
above described.
Issued by Authority of Chapter 14.15 Revised Code of Washington.
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for children at
LICENSE NUMBER
70-017099
PROVIDER NUMBER
597286
The Depar ment of Washington
Department of Social and Health Services
DIVISION OF CHILDREN AND FAMILY SERVICES
Family Child Day Care Home License
In compliance with and pursuant to the laws of the State of Washington in meeting health standards and the minimum licensing
requirements of the Department of Social and Health Services, a license is hereby granted
to LUCENETTE HICKS to provide child day care (less than 24 hours)
city of Spokane
5920 E. 9th.
zip code 99212
, county of
Spokane , State of Washington, in a family home licensed for a
maximum of 6 children on the premises including the provider's own children under twelve years when on the premises.
The providermay have on the premises at any one time: When an assistant is present, the provider may have:
6 children, birth through 11 years of age; or children, birth through years of age.
children, two years through years of age; or
children, three years through years of age; or
children, ages five years through years of age; or
The allowed number of children under two years of age is 2
This license shall be in force from the 9th. day of September
day of September , 19 96 , subject to revocation for due cause.
DATED AT Spokane WASHINGTON,TH�S 14th. .DAY OF September ,19 93
,19 93 , to the 8th.
Joan.4urry LICENSOR/ Connie Bacon LICENSING SUPERVISOR
NOTE: This license is not transferable, and is valid only for use by the individual(s) to whom it is issued and at the location described.
DSHS 10092(X)(aov. 11191) Rime
•
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAT' C38, 1332-21 • Spokane, Washington 99220-4038
September 5, 1995
To Whom It May Concern:
Kid City Daycare at 5920 E. 9th Ave, Spokane has been granted a
provisional license from 9-1-95 to 2-28-96 for 21 children ages lmo
to 12 years, up to five of these children may be under one year of
age.
Sincerely,
c
aL&
Laura Dallison
Office of Child Care Policy
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAP C38, I332-2I • Spokane, Washington 99220-4038
July 28, 1995
Lucenette Hicks, Director
KID CITY DAY CARE
5920 East Ninth Avenue
Spokane, WA 99212
Dear Ms. Hicks:
This letter confirms that the staff names listed below, which
you sent for verification of compliance with WAC 388-73-030, have
been cleared.
Karen Baker
Janis Bentley
Lucenette Hicks
Sincerely,
(442a%GSlirn
Laura Dallison, Licensing Specialist
Office of Child Care Policy
Region 1
Mitchell Hicks
Cathleen Stephens
LD:bsm
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAF C-38, B32-21 • Spokane, Washington 99220-4038
April 24, 1996
Kid City
5920 E. 9th Ave
Spokane, WA 99212
RE: Criminal History Clearance
This letter confirms that the staff names listed below, which you sent for -verification of
compliance with WAC 388-73-030, have been cleared.
Damecca Knight
Sincerely, 2 ,r
tei
inda Ernst, Licensing Specialist
Office of Child Care Policy
Region 1
je
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAF C-38, 832-21 • Spokane, Washington 99220-4038
August 14, 1996
TO: KID CITY DAY CARE
5920 E. 9th
Spokane, WA 99212-0219
FROM: Linda Ernst, Licensing Specialist
Office of Child Care Policy
SUBJECT: Criminal History Clearance
This letter confirms that the staff names listed below, which you sent for verification of
compliance with WAC 388-73-030, have been cleared
Kassie Borden
Angela Conway
je
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAF C-38, B32-2I • Spokane, Washington 99220-4038
January 30, 1997
Lucenette Hicks, Director
KID CITY DAY CARE
5920 East 9th Avenue
Spokane, WA 99212
Dear Ms. Hicks:
This letter confirms that the staff names listed below, which
you sent for verification of compliance with WAC 388-73-030, have
been cleared.
Sandra C. Brown
Kimberly M. Harn
Brenda Eleanor Kelly
Sincerely,
/b(Q
irle
Offi
Region
SH:lrb
Licensing Specialist
are Policy
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
TAF C-38, 832-2I • Spokane, Washington 99220-4038
February 27, 1997
Kid City Day Care Center
5920 E
Spokane, WA 99212
Dear Ms. Hicks:
This letter confirms that the staff names listed below, which you sent for verification of
compliance with WAC 388-73-030, have been cleared_
PandoraGibson
Sincerely,
-tAi ,Cv (O --
inda Ernst, Licensing Specialist
Office of Child Care Policy
Region 1
LSE_tib
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
P.O. Box 2538, B32-21 • Spokane, Washington 99220-4038
June 3, 1997
Kid City Preschool & Day Care
5920E 9th
Spokane, WA 99212
Dear Ms. Hall:
This letter confirms that the staff names listed below, which you sent for verification of
compliance with WAC 388-73-030, have been cleared.
Jeannie M. Everett
Sincerely,
_ma) ksa-
Linda Ernst, Licensing Specialist
Office of Child Care Policy
Region 1
LE:tlb
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
P.O. Box 2538, B32-21 • Spokane, Washington 99220-4038
August 26, 1997
Lucenette Hicks, Director
KID CITY DAYCARE
5920 E. 9th Ave.
Spokane, Wa. 99212
Dear Lucenette Hicks,
This letter confirms that the staff names listed below, which you sent for verification
of compliance with WAC 388-73-030, has been cleared.
Sincerely,
Beck, Larry Jr. David
Zi-n-dbc
Linda Ernst, Licensing Specialist
Office of Child Care Policy
Region 1
LE:ge