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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414778
Report Date: 12/17/2021
Date Signed: 12/17/2021 02:15:46 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 UNIDOSFACILITY NUMBER:
434414778
ADMINISTRATOR:LISETTE MEJIAFACILITY TYPE:
850
ADDRESS:1970 CINDERELLA LANETELEPHONE:
(408) 471-6399
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY:48CENSUS: 3044DATE:
12/17/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:13 PM
MET WITH:Laura De Jesus, Lead TeacherTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA), James Santos arrived at the facility today to conduct a case management visit. LPA met with Lead Teacher, Laura De Jesus. Site Director, Josefina Garcia was not present in the facility during today's visit.

The purpose of today's visit was to continue the case management visit conducted on 12/9/2021 in regards to the incident that the Site Director self reported to the Department that occurred on December 7, 2021 when one of the child left the classroom and was observed playing by himself in the playground area by a parent and was brought back to the classroom. The incident occurred during pick up time between 3:34 PM and 3:39 PM.

During the course of the investigation, LPA spoke with Ms Sandra (Teacher) regarding the incident. Ms Sandra stated she was helping with the pick up of the children and they were by the door which was slightly open. She stated that she saw in the corner of her eye the child exiting the classroom so she followed him right away to get him. Ms Sandra stated that the child was in her line of vision the whole time. LPA was also able to interview a parent who was picking up her son. Per interview with the parent, the parent had just arrived and was walking towards the classroom when she saw the teacher, Ms Sandra running after the little child and was brought back to the classroom unharmed and was doing fine.


No further investigation needed. No deficiencies cited. Exit interview conducted.


A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
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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