434406751-3-7-2024-07-CC-SCHN-D363EM-20240307171119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434406751
Report Date: 03/07/2024
Date Signed: 03/07/2024 05:11:35 PM

Document Has Been Signed on 03/07/2024 05:11 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	KIDANGO ARBUCKLE		FACILITY NUMBER:	434406751
ADMINISTRATOR:	VANESSA PAIZ		FACILITY TYPE:	850
ADDRESS:	1910 CINDERELLA LANE		TELEPHONE:	(408) 905-8985
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95116
CAPACITY:	40	CENSUS: 30	DATE:	03/07/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Venessa Paiz		TIME COMPLETED:	04:30 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	Page 1. On 3/7/24 Licensing Program Analyst (LPA), Sheena Chin, conducted an unannounced Required - 3 year inspection of the Preschool. LPA met with the director, Vanessa Paiz, and explained the purpose of the visit. The Facility is licensed to serve age 2 years through entry to kindergarten in room #75 and #77, ambulatory. Hours of operation: 7:30 AM to 5:30 PM Monday to Friday. The director stated that the facility does not have weapons on the premises, that smoking is not allowed on the premises and that the facility administered medications when needed. The director stated that the facility provided food. Observation LPAs toured the indoor and outdoor areas of the Facility. 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 were observed. The facility passed the fire inspection on 10/10/23. LPA observed fully charged Fire Extinguishers, functioning smoke/carbon monoxide detectors, First Aid Kit, central heating, and air conditioning in all rooms. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Restrooms for children to use were observed to be in operating condition. Play equipment were maintained in a good condition, free of hazards. continue to page 2.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO ARBUCKLE	FACILITY NUMBER: 434406751
	VISIT DATE: 03/07/2024

NARRATIVE

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Observation
The facility provides two meals (Breakfast and Lunch) and snacks. Meals are prepared and packaged by the facility's "Nutritional Department," which is off site, and then delivered to the facility. The food storage areas were clean, free of litter, rubbish, and rodents/vermin. Foods and beverages were kept protected against contamination and spoilage. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Trash cans for solid waste had tight-fitting covers on.

The teacher/child ratio was in compliance during today's inspection. 18 preschool children with 3 teachers in room #75, and 12 preschool children with three teachers in room #77. The director stated that she understood the conditions, limitations, and capacity specifications of the Facility license and that children shall be always supervised within the classroom and in the playground areas.

The playground area was surrounded by appropriate fencing. Shade is provided by trees in the playground area. The outdoor equipment is age-appropriate and in good condition. There is a climbing structure in the playground that is age appropriate. Rubber surfacing is used as resilient material throughout the playground. Areas around and under high climbing equipment were cushioned with material that absorbs falls. There were no bodies of water observed.

Records review
Disaster drills shall be conducted at least every six months and be maintained for at least one year. The last drills were conducted on 12 / 6 / 23 . LPA reviewed facility's sign in/out procedure and record. A sampling of children and staff files was selected for review. Children records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Medical Assessment, and immunization. Staff records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. S3 did not have the current mandated reporter training certificate.LPA advised the director that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA' inspection.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO ARBUCKLE	FACILITY NUMBER: 434406751
	VISIT DATE: 03/07/2024

NARRATIVE

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Records review
LPA advised the director that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Discussion
Water lead test: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed on 11/1/22 in accordance to the Written Directives outlined in PIN 21-21.1.CCP. LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

Incidental Medical Services (IMS): This facility provided Incidental Medical Services – IMS.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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO ARBUCKLE	FACILITY NUMBER: 434406751
	VISIT DATE: 03/07/2024

NARRATIVE

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Deficiency
Regulatory violations were observed during the inspection. Citations were issued.

Further questions
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit
Exit interview was conducted, where this report, the citation, plan of correction, and appeal rights were reviewed and discussed with Licensee, Vanessa Paiz.
Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 03/07/2024 05:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO ARBUCKLE	FACILITY NUMBER: 434406751
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. S3 did not have current mandtaed reporter training certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/14/2024
	Plan of Correction
1 2 3 4	The director will send LPA the copy of the mandated reporter training certificate for S3.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Gladys Kuizon	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Sheena Chin	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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