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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420602
Report Date: 10/27/2022
Date Signed: 10/27/2022 01:17:38 PM


Document Has Been Signed on 10/27/2022 01:17 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:KIDANGO - DAYTONFACILITY NUMBER:
013420602
ADMINISTRATOR:SITU, BAOXIANFACILITY TYPE:
850
ADDRESS:1500 DAYTON AVETELEPHONE:
(510) 901-1556
CITY:SAN LEANDROSTATE: CAZIP CODE:
94579
CAPACITY:24CENSUS: 10DATE:
10/27/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:27 PM
MET WITH:Baoxian SituTIME COMPLETED:
01:20 PM
NARRATIVE
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On Thursday 10/27/2022 at approximately 12:30 pm Licensing Program Analyst Sabina Dodoo met with Director Baoxian Situ for an Unannounced Case Management Visit for Lead Testing Result at Kidango Dayton Preschool.Present for the inspection were Director and 2 staff. The census was 5 children. The facility operates Monday through Friday 8am to 4:30pm.

LPA and Director toured the facility and LPA obtained photos of the faucets in the classrooms. A Plan of correction was discussed with the Director. This facility is being given a Type B citation for California Code of Regulations ,Title 22, Division 12 Chapter 1 Regulation number: 101238(a) Buildings and Grounds.(Please see LIC 809D page for citation and Plan Of Correction details).

Exit interview was conducted with Director Baoxian Situ. A copy of this report was provided. A notice of site visit was given and appeal rights. This report shall remain on file for 3 years.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2022
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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Document Has Been Signed on 10/27/2022 01:17 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: KIDANGO - DAYTON
FACILITY NUMBER: 013420602

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/27/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/27/2022
Section Cited

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101238(a) Buildings and Grounds
(a)The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
This requirement is not met as evidenced by:
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The facility had a faucet that had lead level exceedance of more than 5.5ppb. This poses a potential health, safety and personal rights risk to children in care. LPA observed the faucet has been covered and is not in used. The facility provides filtered water to children in care.
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The proof of correction must be submitted no later than 11/27/2022 by email at : Sabina.Dodoo@dss.ca.gov

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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: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 10/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2022
LIC809 (FAS) - (06/04)
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