073406696-10-26-2020-02-CC-SJON-BV7PV9-20201109103845

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073406696
Report Date: 10/26/2020
Date Signed: 10/26/2020 04:21:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/18/2020 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20200918160409

FACILITY NAME:	KIDANGO - BALDWIN		FACILITY NUMBER:	073406696
ADMINISTRATOR:	VASSEGHI, MINOO		FACILITY TYPE:	850
ADDRESS:	2750 PARKSIDE CIR		TELEPHONE:	(925) 798-5021
CITY:	CONCORD	STATE: CA	ZIP CODE:	94519
CAPACITY:	65	CENSUS: 20	DATE:	10/26/2020
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Minoo Vasshegi		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Failure to report incident to parent

INVESTIGATION FINDINGS:

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On 10/26/20 at 3:15 PM Licensing Program Analyst (LPA) Monica Mathur conducted an Unannounced Subsequent Complaint Investigation at Kidango Baldwin Childcare Center via video conference due to COVID restrictions. LPA met with Director, Minoo Vasshegi and the finding for the above allegation was delivered.

Complainant alleges that facility failed to report an incident to parent. During the course of the investigation, LPA inspected the facility, reviewed records, and conducted interviews. During an incident a child disclosed to staff about discomfort in the private area. Staff did not write an ouch report and failed to notify parents and Director. Director became aware of the incident when parent notified her. This poses a potential risk to the health and safety of children in care. Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

Exit interview was conducted, where this report, the deficiency, plan of correction, and appeal rights were discussed with Director, Minoo Vashegi. This report is signed by analyst and will be sent to Director to obtain her signatures. Signed report to be returned by end of 10/28/20.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20200918160409

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO - BALDWIN	FACILITY NUMBER: 073406696
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/26/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/28/2020 Section Cited CCR 101212(f)	1 2 3 4 5 6 7	101212 Reporting Requirements (f) The items specified [...] shall also be reported to the child's authorized representative. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	By POC Due Date 10/28/20 Director agreed to hold staff training to discuss CCL reporting requirments. Director will send to CCL a copy of the training agenda and staff attendance.
	8 9 10 11 12 13 14	Per LPA's investigation, it was found that during an incident a child disclosed to staff about discomfort in the private area. Staff did not write an ouch report and failed to notify parents and Director. Director became aware of the incident when parent notified her. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2020

LIC9099 (FAS) - (06/04)

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