013415911-5-25-2022-52-CC-JSAI-CERNXG-20220525105108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013415911
Report Date: 05/20/2022
Date Signed: 05/25/2022 10:51:18 AM

Document Has Been Signed on 05/25/2022 10:51 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	KIDANGO-KITAYAMA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	013415911
ADMINISTRATOR:	AGUINALDO, GINA		FACILITY TYPE:	850
ADDRESS:	1959 SUNSPRITE DRIVE		TELEPHONE:	(510) 675-7104
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY:	22	CENSUS: 11	DATE:	05/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Director Gina Aguinaldo		TIME COMPLETED:	11:15 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Jyoti Saini met with Director Gina Aguinaldo for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the staff. In addition to the director, there are 11 children and 2 sub teachers present today. The program consists of two half day sessions: 8:00am to 11:00 am and 11:45 am to 2:45 pm Monday - Friday in room #5 on the Kitayama Elementary School Campus. The facility was inspected indoor and outdoor today for health and safety hazards and the following was observed; There are no bodies of water, firearms, or weapons on the premises. The center is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. The children and staff have a separate bathrooms. The bathrooms appear to be safe, sanitary, and free of any hazardous items. There is drinking water readily available through water pitcher. There is a menu posted for the entire month. Food is prepared and delivered by Kidango, Inc. The classroom has appropriate postings. The last Emergency Drill was conducted on 05/09/22 and is properly logged. Outdoor play area was free of hazards and provided a shaded area for the children. Medications are stored on a high shelf which is inaccessible to children in care. The Facility roster is complete and LPA obtained a copy of the roster. LPA reviewed sign-in and out sheet. The center has a complete record of sign-in/out sheets by an authorized pick up person. There are multiple first aid kits available. There is a working fire alarm system at the elementary. The room has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. All children have a record of emergency identification information and immunization record on file. Staff records reviewed were complete. All staff has a criminal record clearance on file. The site Director and staff has a current Pediatric First Aid/CPR certificate on file see next page.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO-KITAYAMA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 013415911
	VISIT DATE: 05/20/2022

NARRATIVE

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During inspection,

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS (Incidental Medical Services) to children currently. If any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report was reviewed with the director, Gina Aguinaldo.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

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