013415911-5-4-2023-52-CC-BPLY-CRHVAC-20230504161543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013415911
Report Date: 05/04/2023
Date Signed: 05/04/2023 04:16:02 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/04/2023 04:16 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 SOUTH EAST, 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: 0	DATE:	05/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Gina Aguinaldo		TIME COMPLETED:	04:30 PM

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	On 5/4/23, Licensing Program Analyst (LPA) Briana Plumboy met with Center Director Gina Aguinaldo for an ANNUAL RANDOM INSPECTION. Also present for the inspection were 2 fingerprint cleared staff. The center is located on the campus of Kitayama Elementary School inside room 5. The facility has a waiver for outdoor activity space. LPA toured the facility and play yard for a health and safety inspection. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The teacher/child ratio was being met. The sign in/out was reviewed and matched the physical census of the children. The classroom and play yard were age appropriate and in good repair during the inspection. Director is aware the play structure must follow all manufacture guidelines and be age appropriate for children to use. Bathrooms were clean and in working order. The trash cans have tight fitting lids. Meals are prepared and delivered by Kidango, Inc. There is a menu posted for the entire month. The kitchen area was maintained in a clean manner. There is water readily available. The program consists of two 1/2 day sessions; napping equipment is not needed. All posting requirements are being met. Outdoor play area was free of hazards during the inspection and provided a shaded area for the children and access to drinking water. Medications are dispensed at this facility. There is a working telephone at the facility. All staff have current CPR and first aid training. Staff have required provider immunization's and mandated reporter training certificates. The center is conducting fire/disaster drills with the last one conducted today on 5/4/23. This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes 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 The facility has and is implementing their IMS Plan. See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO-KITAYAMA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 013415911
	VISIT DATE: 05/04/2023

NARRATIVE

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California Law requires Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

The Director is reminded any structural changes to the center or additions to the child care facility must be reported to Community Care Licensing. Director was reminded of Departments inspection authority, with our without any notice.

Director is reminded that ALL Staff must be fingerprint cleared prior to being in the presence of children in care, or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Director was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

LIC809 (FAS) - (06/04)

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