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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420561
Report Date: 08/30/2023
Date Signed: 08/30/2023 12:54:58 PM


Document Has Been Signed on 08/30/2023 12:54 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 - SUNSETFACILITY NUMBER:
013420561
ADMINISTRATOR:ANDREA CABRALFACILITY TYPE:
850
ADDRESS:20450 ROYAL AVETELEPHONE:
(510) 901-1544
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY:24CENSUS: 11DATE:
08/30/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Jenny BernadosTIME COMPLETED:
01:00 PM
NARRATIVE
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On August 30, 2023 at 12:00 PM., Licensing Program Analyst (LPA) Elimika Woods conducted a Case Management Lead Testing/Exceedance inspection due to the center's lead testing results. LPA met with the facility representative Jenny Bernados . Present during the inspection were 11 preschool age children and three additional staff members.

The department was notified that one (1) drinking fountain located on the inside of classroom (B) have elevated lead levels that have exceeded 5.5 ppb. This exceeds the Action Level (ALE) established by the state for lead exposure. Per director Jenny Bernados, these faucets were immediately closed off and removed. LPA observed today the faucets are removed and capped off and not in use. LPA also observed posting of lead testing results.

See LIC 809-D for deficiencies cited during today's inspection.

Exit interview conducted with the facility representative Jenny Bernados. A notice of site visit was provided and must be posted for 30 days.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2023
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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Document Has Been Signed on 08/30/2023 12:54 PM - It Cannot Be Edited

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 - SUNSET
FACILITY NUMBER: 013420561

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2023
Section Cited

101700.3(b)(1)

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101700.3(b)(1)-Lead Testing Written Directive- A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance (ALE)
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LPA observed the drinking outlet have been closed by a cap.
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This requirement is not met as evidenced by: Based on record review, the facility has one outlets on the inside of the classroom that have an ALE of 5.5 ppb or greater, which poses a potential health and safety risk to persons in care.
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Cleared by inspection on 8/30/23

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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: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika WoodsTELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2023
LIC809 (FAS) - (06/04)
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