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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700536
Report Date: 03/13/2025
Date Signed: 03/13/2025 04:26:23 PM

Document Has Been Signed on 03/13/2025 04:26 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDANGO PEIXOTOFACILITY NUMBER:
015700536
ADMINISTRATOR/
DIRECTOR:		FAGUNDES, VIRGINIAFACILITY TYPE:
850
ADDRESS:29150 RUUS ROADTELEPHONE:
(510) 516-7378
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 67TOTAL ENROLLED CHILDREN: 67CENSUS: 30DATE:
03/13/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Maria AcostaTIME VISIT/
INSPECTION COMPLETED:
04:40 PM
NARRATIVE
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On March 13, 2025 at approximately 3:00 PM, Licensing Program Analyst (LPA) Elimika Woods arrived unannounced for a Case Management Inspection at Kidango Peixoto for an Unusual Incident reported on 03/07/2025. LPA Woods meet with Site Director, Maria Acosta and explained the purpose of the inspection. Present during today's inspection were thirty (30) preschool age children and eight additional staff members.

The purpose of the site visit was to follow up on an unusual incident filed on March 7, 2025. The director of the preschool reported on 03/06/2025 at 3:45 PM, in classroom #187 a four year old child was left alone. As a result, there was an Absence of Supervision.

LPA Woods conducted an interview with the Site Director, Maria Acosta who re-told the story. Staff (S1) was called in through the facility pager and was asked to help at the front of the facility. Teacher S1, without realizing C1 was still napping at this time, stepped out of the room to help someone at the front of the facility. After 4-5 minutes, Teacher S1 came back to the classroom #187 and she saw C1 still napping on her mat. Teacher S1 woke up C1 and picked her up and brought her to the other children with the teachers at the outdoor play area. teacher S1 walked to the Director and reported the incident.

LPA inspected the premises and rooms, observed staff on the outside playground area, and staff interactions with the children and obtained documents.

Deficiency was cited during today's inspection see 809-D. This report was reviewed and discussed with Site Director, Maria Acosta, who signed it acknowledging receipt of documents. Facility will provide LIC 9224 to every current family and any new families for the next 12 months.

A notice of site visit was issued must be posted for 30 consecutive days. Appeals Rights provided and exit interview conducted with the Site Director, Maria Acosta.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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Document Has Been Signed on 03/13/2025 04:26 PM - It Cannot Be Edited


Created By: Elimika Woods On 03/13/2025 at 03:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO PEIXOTO
FACILITY NUMBER: 015700536

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/13/2025
Section Cited
CCR
101229(a)(1)

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Title 22 Division 12, Chapter 1, Section 101229(a)(1) No Child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual supervision.

This regulation not met as evidence by:
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Per Director, all staff will attend a meeting about active supervision procedures and protocols for supervising children in care. Each staff member will sign and date the provided Active Supervision statement.
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The facility did not ensure proper supervision resulting in a child being left alone in a classroom for approximately 4-5 minutes, which poses a potential health, safety, or personal rights risk to children in care.
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Director will have each staff member sign this written statement as an acknowledgement. Plan of Action on how the school will ensure supervision at all times. The statement will be emailed to LPA Elimika.woods@dss.ca.gov by 03/13/2025.

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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.
SUPERVISOR'S NAME:Chandra Charles
LICENSING EVALUATOR NAME:Elimika Woods
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
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