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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700536
Report Date: 11/06/2023
Date Signed: 11/06/2023 01:05:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2023 and conducted by Evaluator Elimika Woods
COMPLAINT CONTROL NUMBER: 52-CC-20231016102316
FACILITY NAME:KIDANGO PEIXOTOFACILITY NUMBER:
015700536
ADMINISTRATOR:FAGUNDES, VIRGINIAFACILITY TYPE:
850
ADDRESS:29150 RUUS ROADTELEPHONE:
(510) 516-7378
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:67CENSUS: 37DATE:
11/06/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Nadine JacintoTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Neglect/Lack of Supervision-Staff did not provide adequate supervision to a daycare child
INVESTIGATION FINDINGS:
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On November 6, 2023 at 12:00 PM Licensing Program Analysts (LPA) Elimika Woods conducted an unannounced inspection to conclude a complaint investigation and met with the facility representative, Nadine Jacinto and advised her the purpose of the inspection. There was 37 preschool age children and 10 additional staff members present during the visit. The facility was toured inside and out by the LPA and representative.

LPA conducted an interview with the facility resprentative regarding the allegations that the staff did not provide adequate supervision to a daycare child. Based on the interview conducted, this agency has investigated the complaint alleging that staff did not provide adequate supervision to a daycare child, the preponderance of evidence standard has been met, Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

LPAs discussed with licensee the seriousness of the substantiated finding for this complaint. Exit interview was conducted, where this report, the deficiency, plan of correction, and appeal rights were discussed with the facility representative Nadine Jacinto.
Substantiated
Estimated Days of Completion: 15
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 52-CC-20231016102316
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO PEIXOTO
FACILITY NUMBER: 015700536
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2023
Section Cited
CCR
101229(a)(1)
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CCR 101229(a)(1) The licensee shall provide care and supervision as necessary to meet the children's need. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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The facility representative will hold a staff meeting with all staff members and talk about Care & Supervision requirements and the staff will view the Supervising Children in Care Centers training video on the CCLD website www.cdss.ca.gov. The facility representative will mail or email a copy of the meeting agenda and a signed attendance sheet from each employee for proof of having attended this meeting. to the LPA by 12/06/23.
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Based on interview, 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 when the staff did not prevent a child from being injured an from other child when they threw a wooden object and hit another child in the head.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023
LIC9099 (FAS) - (06/04)
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