434412429-6-9-2022-07-CC-AALZ-CF8U7G-20220609151956

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412429
Report Date: 06/09/2022
Date Signed: 06/09/2022 03:28:13 PM

Document Has Been Signed on 06/09/2022 03:28 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	KIDANGO MEADOWFAIR		FACILITY NUMBER:	434412429
ADMINISTRATOR:	YADIRA RIOS		FACILITY TYPE:	850
ADDRESS:	2696 SOUTH KING ROAD		TELEPHONE:	(408) 353-0680
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY:	30	CENSUS: 12	DATE:	06/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Kindle, Vera		TIME COMPLETED:	03:45 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	Licensing Program Analysts (LPAs) Almaraz, Celi and Berumen, Elizabeth met with teacher Vera Kindele for an unannounced Required - 1 Year inspection. LPA toured the indoor and outdoor areas of the Facility during today's inspection. LPAs observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. This is a half day program, AM session 7:45 AM to 10:00 AM and 11:30 AM to 2:30 PM, both programs Monday to Friday. The facility is licensed to serve children ages 2 to entry into 1st grade. LPAs reviewed 6 children's and three staff files during today's inspection. Each child's file reviewed contains the required forms. LPAs observed at least one staff present during the inspection has current Pediatric CPR/First Aid certifications. Per record review, all Staff have current Mandated Reporter Training for Child Care Workers. Licensee understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). LPAs reminded staff that the online Assembly Bill (AB)1207 Mandated Reporter Training needs to be renewed every two years (www.mandatedreporterca.com). LPAs observed that the teacher/child ratio was in compliance during today's inspection. LPAs observed 12 children with three staff present in the classroom, two teachers and one aid. Staff understands the conditions, limitations, and capacity specifications of the Facility license. Staff understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in a separate area. Staff states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Staff understands that the Facility must be kept free of flies and other insects & rodents. LPAs observed that all furniture and equipment is in good condition and safe for the children. Drinking water is readily available for the children in the Room and in the outdoor playground area via water pitches and disposable cups indoor/outdoor. Staff ( 1 toilet and 1 sink) and children's bathrooms (2 toilets and 2 sinks) are operable. There are two additional sinks. There is a separate staff bathroom not utilized by the children, an isolated child can use if needed. Staff states that there are no weapons or firearms on the premises. The Facility has functioning smoke carbon monoxide detectors in each Room. LPAs observed a fire extinguisher, 3A40BC last serviced on 06/10/2021, LPAs reminded Vera that this must be serviced no later than 06/10/2022, failure to do this may result in a deficiency. Continuation on next page:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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 MEADOWFAIR	FACILITY NUMBER: 434412429
	VISIT DATE: 06/09/2022

NARRATIVE

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The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees Fahrenheit or less. Food is prepared in the main Kidango Kitchen in Fremont.

The Facility has trash can with tight fitting lid for the disposal of solid waste. Cleaning supplies are inaccessible to the children and stored under sink in locked cabinets. LPA observed a complete First Aid kit in the Facility.

This facility provides Incidental Medical Services – IMS. Site Director states that none of the children enrolled is using medication. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. Shade is provided canopies. There is sufficient rubberized resilient material in the outdoor playground area. LPA's did not observe any bodies of water.

Vera Kindle 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.
Facility has a waiver for central administrative file for criminal record purposes. Failure to comply with conditions of the waiver may result in termination of the waiver, citations and/or deficiencies.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPAs conducted an Exit interview and report was reviewed with Vera. Deficiencies cited on following 809 D pages.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/09/2022 03:28 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO MEADOWFAIR	FACILITY NUMBER: 434412429
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.3(b)

Indoor Activity Space

(b) The floors of all rooms shall have a surface that is safe and clean. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPAs observation the facility did not comply with the section cited above for failure to comply with clean flooring in the childrens bathroom which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2022
	Plan of Correction
1 2 3 4	Facility staff agrees to have the flooring of the bathroom deep cleaned, including the walls on or before this date. Proof of correction will be sent via email araceli.almaraz@dss.ca.gov photos on or before POC due date.

Type B

Section Cited

CCR

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:
	Deficient Practice Statement
1 2 3 4	Based on LPAs observation the licensee did not comply with the section cited above.There is a potental crawl space that could be used as a hiding spot, below the storage shed, which poses/posed a potential health, safety or personal rights risk to persons in care. There is a dishwasher that must be replaced, that omits an odor, this poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2022
	Plan of Correction
1 2 3 4	Licensee agrees to fix potential crawl space and order a new dishwasher. Proof of repair of crawl space and purchase of diswasher to be sent by photo via email noted on or before POC due date.

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: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/09/2022 03:28 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO MEADOWFAIR	FACILITY NUMBER: 434412429
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(2)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPAs observation the play ground area has dry grass and debris, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2022
	Plan of Correction
1 2 3 4	Licensee has agree to landscape and remove debris on or before the POC due date. Licensee will send photos via email noted to LPAs.

Type B

Section Cited

CCR

101170(e)(2)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review licensee failed to comply with waiver conditions. Licensee failed to submit an update personel report LIC 500, reflecting LourdesTrinidad Martinez,
	POC Due Date: 06/14/2022
	Plan of Correction
1 2 3 4	Licensee agrees to comply with the four conditions listed on the waiver. Licensee will submit a statement that they understand these requirements and an updted LIC 500 reflecting LourdesTrinidad Martinez, This will be submitted via email on or before POC due date.

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: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/09/2022 03:28 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO MEADOWFAIR	FACILITY NUMBER: 434412429
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation the last drill was logged 09/14/2021, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2022
	Plan of Correction
1 2 3 4	Licensee agreed to practice and document fire disaster drill for AM and PM class. Licensee will email LPAs on or before POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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