<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420603
Report Date: 04/20/2022
Date Signed: 04/20/2022 11:16:40 AM


Document Has Been Signed on 04/20/2022 11:16 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 - BAYFACILITY NUMBER:
013420603
ADMINISTRATOR:UTSEY, SIMONEFACILITY TYPE:
850
ADDRESS:2001 BOCKMAN ROADTELEPHONE:
(510) 901-1554
CITY:SAN LORENZOSTATE: CAZIP CODE:
94580
CAPACITY:24CENSUS: DATE:
04/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:32 AM
MET WITH:SIMONTE UTESYTIME COMPLETED:
12:30 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 4/20/2022 at 9:58am, Licensing Program Analyst (LPA) met with Director (Simone Utsey) for a Required 1-Year Inspection. Present for this inspection are the Director, 3 fingerprint cleared and associated staff members, and (14) preschool aged children in care. The facility operates Monday - Friday 7:30AM-4PM. This facility operates on the campus of Bay school in room 115. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the visit. The toilets and sinks were in operable condition. The floors are free of tripping hazards. All storage containers for solid waste have tight-fitting covers that are in good repair. Drinking water is available both indoors and outdoors. Snack menus are posted and visible for parents to review. There are no pools or similar bodies of water at this facility. Outdoor activity space and playground equipment appear to be safe and free of hazards. Climbing equipment is properly anchored to the ground with adequate and appropriate cushioning material to absorb falls. There is a shaded area provided for the children. Fire/Disaster Drills are conducted on a monthly basis (the last one was conducted March 23, 2022). The facility is operating within its licensed capacity. The facility is within ratio today with one teacher supervising no more than 12 children. LPA did not observe any child left without visual supervision or unattended during the inspection. All staff have required immunization and mandated reporter training certificates. All staff have proof of a current First Aid/CPR certificate. At 10:35 am, children and staff files were reviewed. Children's files reviewed contained emergency information and medical assessments. Staff records reviewed contain required health screening. At 9:42am, LPA toured the facility classroom. The facility consists of one rooms used for daycare. The classroom is tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the classrooms. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. LPA observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection. No cleaning supplies were observed to be accessible to children during today's inspection. At 10:17am, LPA toured the kitchen/food preparation area. The kitchen is free of litter, garbage, and evidence of rodents or other vermin during this inspection. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Food/beverages capable of rapid spoiling are properly stored. Solid waste storage vessels (garbage cans) have tight fitting covers. Uncontaminated drinking water is available to children inside and outside the facility.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney CortezTELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


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 - BAY
FACILITY NUMBER: 013420603
VISIT DATE: 04/20/2022
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
26
27
28
29
30
31
32
At 10:05am, LPA toured the outdoor play area. Equipmenst have cushioning material to absorb falls. There are no pools, hot tubs, ponds, or any other bodies of water accessible to children during today's inspection.
At 10:46am, LPA reviewed sign in/sign out sheet. LPA observed 14 signatures out of 22 children present in the facility during today's inspection. Facility uses a digital sign in-sign out system.
The facility has one fully charged 3A40BC fire extinguishers, working carbon monoxide detector, and working telephone. Smoke detector is wired to notify the fire department when triggered. Per Director, smoke detector is fully functional and serviced regularly. At least one staff member has current CPR/1st Aid certificate. The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view, including menus. Fire/disaster drills are conducted at least once every 6 months. Daily activity schedule is present in facility. Facility roster was obtained.

Incidental Medical Services (IMS) policy was discussed. This facility does not provides IMS to children in care at this time. 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.”

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.

Director was reminded that California Law requires licensed 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. LPA informed the Director that all forms can be downloaded at www.ccld.ca.gov and encouraged the Director to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Director was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.



LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

There are no deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director. Appeal rights were provided to the Director and the signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney CortezTELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2