434415706-12-3-2019-07-CC-SRED-BJJ2U5-20191203164145

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415706
Report Date: 12/03/2019
Date Signed: 12/03/2019 04:41:50 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 FOXDALE		FACILITY NUMBER:	434415706
ADMINISTRATOR:	NGLEGE WILLIAMS		FACILITY TYPE:	830
ADDRESS:	1250 FOXDALE LOOP		TELEPHONE:	(408) 290-7666
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY:	16	CENSUS: 13	DATE:	12/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Thao Nguyen		TIME COMPLETED:	04:55 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 Analyst (LPA) Shannel Reed met with Center Director, Thao Nguyen for an unannounced annual/random inspection. LPA toured the indoor and outdoor areas of the Facility during today's inspection. LPA notes that the Infant Program is licensed in Room 167. The Facility also has a Preschool Program (#434415705) on site in room 168 of the same building. LPA 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. LPA observed that the teacher/child ratio was in compliance during today’s visit with three (3) teachers and one (1) Aide with 13 children. The Center Director understands the conditions, limitations, and capacity specifications of the Facility license. The Center Director understands that infants shall be visually supervised at all times and never left unattended. LPA reviewed four (4) children’s files. LPA observed the medical assessment, immunization's, Information and Emergency Information form (LIC 700) and additional documentation is complete. LPA reviewed the Individual feeding plans and the Needs and Services plans for the infants in care which are stored in the classroom. LPA observed that 3 out of the 6 plans reviewed have not been updated at least quarterly as required. A review of staff records indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reviewed three (3) infant teachers staff files. All three (3) Infant Teachers have a current CPR/ First Aid Certifications on file. The Center Director 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). THe Center Director understands the conditions, limitations, and capacity specifications of the Facility license. The Center Director understands that children shall be visually supervised at all times. LPA observed that the Immunization's against Measle, Pertussis and Influenza (or an opt-out statement) and the required Mandated Reporting Training (AB1207) are completed and on file for each teacher. Facility Evaluation Report dated 12/03/19 to be continued on next page:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

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 FOXDALE	FACILITY NUMBER: 434415706
	VISIT DATE: 12/03/2019

NARRATIVE

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Facility Evaluation Report dated 12/03/19 continued from previous page:
LPA observed that the classrooms are clean and safe for all children and staff. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed located inside the classroom. Drinking water is readily available for the children inside and outside via a filtered water pitcher and disposable cups. LPA observed solid waste containers with tight-fitting lids in the classroom and in the playground area.
The Center Director states that there are no weapons on the premises. Lunch and snacks are provided by the center. Lunch is prepared in the off-site kitchen and brought to the facility. Food is stored in the on-site refrigerator in the Staff Room/ Office. The food preparation area is adequately equipped with refrigerators, and hot and cold running water and a microwave. There is also adequate food for snacks and regular meals for the children. Cleaning supplies are stored inaccessible to the children. Any medications at the center are stored in a upper cabinet in the classroom and is inaccessible to the children in care. First Aid kit is stored in the classroom, out of reach of the children. The Center Director states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. LPA observed all furniture and equipment is in good condition and safe for the children. The infant changing table has raised sides that are at least 3 inches in height. Napping equipment is appropriate.

LPA observed all furniture and equipment is in good condition and safe for the children. 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. LPA observed no bodies of water.
LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the Center Director can obtain updated licensing information, new regulations and access forms. LPA advised the Center Director of their responsibility to stay current in regard to new regulations. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list childcareadvocatesprogram@dss.ca.gov. LPA discussed and provided Lead Safety information (AB 2370).

LPA obtained a Facility roster and conducted an exit review with the Center Director.
No Title 22 Deficiencies were observed during today’s inspection.
A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

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