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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416145
Report Date: 06/23/2021
Date Signed: 06/23/2021 11:36:50 AM

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 ANDREW HILLFACILITY NUMBER:
434416145
ADMINISTRATOR:MAI TONFACILITY TYPE:
850
ADDRESS:3200 SENTER ROADTELEPHONE:
(408) 928-5211
CITY:SAN JOSESTATE: CAZIP CODE:
95111
CAPACITY:27CENSUS: 14DATE:
06/23/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Angelica GalvanTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA), Fermin Campos-Jaramillo made an unannounced one year required inspection to the center today. LPA met with acting director Angelica Galvan, and explained the nature of today's inspection to her. LPA observed 14 children were in care today. LPA observed there were three staff members taking care of the children. LPA observed that all the staff members present during the inspection have a current CPR/First Aid certifications. LPA observed the teacher-child ratio was in compliance with regulations. LPA observed posted the forms required by this Licensing Department.

LPA toured the facility inside and outside. Staff and children's toilets and sinks are safe and in sanitary operating conditions. LPA observed the storage areas are clean and free of litter. LPA observed disinfectants, cleaning solutions, sharp objects, and other similar items are stored inaccessible to children. LPA observed there is a first aid kit inaccessible to children. LPA observed posted a menu with the food provided by the center.
LPA observed the center is equipped with refrigerator, dishwasher, microwave oven and sink with running water in the food preparation area. Ms. Galvan stated the food is prepared at the Kidango main facility in Fremont CA. LPA observed the facility has a functioning smoke detector and a fire extinguisher type 3A40BC last serviced on April 2021. LPA observed that drinking water is readily available indoor via water fountain. LPA observed there are trash cans with tight fitting covers for the disposal of solid waste. LPA observed the center has at least one working Carbon Monoxide detector.
Ms. Galvan states that there are no weapons in the premises. Playground areas are surrounded with appropriate fencing and not bodies of water. LPA observed that all furniture, equipment and playground equipment is safe and in good conditions, free of sharp, loose, or pointed parts. LPA observed that shade in the playgrounds is provided by tarps. LPA observed that outdoors water is provided via water fountain. LPA observed there are rubber tiles as resilient material under the climbing structure in the playground. LPA observed all floors were clean and safe.

REPORT DATED 6/23/21 CONTINUES ON PAGE #2
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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 ANDREW HILL
FACILITY NUMBER: 434416145
VISIT DATE: 06/23/2021
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Report dated 6/23/21 continues from page 1.

LPA observed that a fire drill was documented on 6/08/21. LPA obtained a copy of the children's roster. LPA reviewed a random sample of six children's files and found in them the Identification and Emergency Information form, the Physician Report form, the Child Preadmission Health Report form, and the Parents Rights form. LPA reviewed the sign-in, sign-out sheets and are signed with full signatures. LPA observed there was a medical assessment document and a preadmission health history document in each child’s record. LPA observed there are records in each personnel file documenting the educational background of the staff.
LPA observed on the Licensing Information System (LIS) report dated 6/22/21 that all the staff present has obtained a criminal records clearance or exemptions. LPA reminded Ms. Galvan of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month-period.
Ms. Galvan stated there are not children under medication currently enrolled in the center.
For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.
LPA observed that all the staff has obtained proof of completion of the mandated reporter training AB1207. LPA referred Ms. Galvan to the Department website: www.mandatedreporterca.com for additional information on the online training. LPA observed that all the staff members present today have proof of immunization for measles, pertussis and influenza in file in compliance with the SB792.

There were not deficiencies cited during today's inspection.
Exit interview was conducted with Ms. Galvan. LPA provided Ms. Galvan with the notice of site visit which has to be visible posted for the following 30 consecutive days.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021
LIC809 (FAS) - (06/04)
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