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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434406756
Report Date: 03/05/2020
Date Signed: 03/05/2020 05:18:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KIDANGO HUBBARD CENTERFACILITY NUMBER:
434406756
ADMINISTRATOR:ANARITA REYESFACILITY TYPE:
850
ADDRESS:1680 FOLEY AVENUETELEPHONE:
(408) 353-0559
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:40CENSUS: 19DATE:
03/05/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Martha GamboaTIME COMPLETED:
05:25 PM
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Licensing Program Analysts (LPA) Dung Mac conducted an unannounced annual inspection to the facility today. LPA met with Martha Gamboa, Site Director at 2:40pm, and explained the nature of today's visit. The Facility is licensed in Rooms 82 and 83. The facility has two sessions (AM class 7:45am-11:15am and PM class 11:45pm-3:15pm).

LPA toured the Facility both inside and outside at 2:50pm. LPA did not observe any bodies of water. Site Director states that there are no weapons or firearms on the premises. LPA observed all required materials posted in both classrooms. LPA observed all children are under supervision at all times.

LPA reviewed staff and children files at 3:05pm. All staff and children files were complete. Staff files contain appropriate documentation of education credits. LPA observed all staff have current CPR and First Aid certifications on file. LPA observed there is a copy of Admission Agreement in each child file. LPA observed child is signed in/out by the person responsible for the child.

LPA observed the teacher/child ratio was in compliance during today's visit. LPA observed cleaning supplies are inaccessible to the children. LPA observed all materials and surfaces accessible to children are toxic free. LPA observed medications are in a safe place inaccessible to children. LPA observed children's bathrooms are in safe and sanitary operating function.

LPA observed the facility is clean and safe for children. LPA observed furniture and equipment are in good condition, free of sharp or pointed parts. LPA observed solid waste containers with tight-fitting lids in classrooms. Meals and snacks are prepared in central location and delivered to the facility. Drinking water is available both indoor and outdoor. LPA observed that there is one functioning carbon monoxide in each classroom.

LPA observed that playground is surrounded by appropriate fencing and locked gated. LPA observed playground area around climbing structure and slide has sufficient resilient materials. Facility is currently administering medications. Incidental Medical Services (IMS) was discussed. The following information regarding ADA was provided: ADA Information Line at (800) 514-0301 (voice) and Commonly Asked Questions available at: http://www.ada.gov/childqanda.htm.

LPA conducted an exit interview with Site Director. No deficiencies were cited during visit. A Notice of Site Visit was issued and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung MacTELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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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