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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406696
Report Date: 04/14/2023
Date Signed: 04/14/2023 02:17:26 PM


Document Has Been Signed on 04/14/2023 02:17 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:KIDANGO - BALDWINFACILITY NUMBER:
073406696
ADMINISTRATOR:VASSEGHI, MINOOFACILITY TYPE:
850
ADDRESS:2750 PARKSIDE CIRTELEPHONE:
(925) 798-5021
CITY:CONCORDSTATE: CAZIP CODE:
94519
CAPACITY:65CENSUS: 35DATE:
04/14/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Minoo VaseghiTIME COMPLETED:
01:30 PM
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On 4/14/23 Licensing Program Analyst (LPA) Monica Mathur met with Director, Minoo Vaseghi to conduct a Case Management inspection for Lead Testing results at Kidango Baldwin Center.

It was indicated that there were at least two (2) outlets which exceeded the Action Level established by the State for exposure. Facility submitted External Water Sampler Self-Certification Form (LIC 9275) for certified external water samplers; Facility Sketch (LIC 999) fully labeled with the locations of all water outlets, including outlets that will not be sampled; Child Care Center Sampling Checklist Form (LIC 9276).

Today on 4/14/23 LPA conducted an inspection and toured the premises with Director. Outlets were in use prior to pandemic outbreak but not been used since. LPA observed outlets have been replaced and new ones installed.

Facility has been in operation in this building for many years. Due to outlets being in use by children before pandemic, children were potentially exposed to lead which is a risk to their health and safety. Deficiency is cited on page 809D. Citation was cleared today because facility has completed remediation process and submitted post testing documents showing clear results.

Exit interview conducted and report was reviewed with the Director, Minoo Vaseghi. A NOTICE OF SITE VISIT was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2023
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 04/14/2023 02:17 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, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: KIDANGO - BALDWIN
FACILITY NUMBER: 073406696

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/14/2023
Section Cited

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Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. This requirement is not met as evidenced by:
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Outlets have been replaced and new ones installed. Post testing has not shown lead exceedance. Citation was cleared today and Letter of Clearance provided.
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Per inspection, there are at least 2 outlets with lead exceedance. Director states outlets have not been used since pandemic. Since they were in use before pandemic, it posed potential risk to health/safety of children.
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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: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2023
LIC809 (FAS) - (06/04)
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