<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434406754
Report Date: 09/20/2024
Date Signed: 09/20/2024 03:31:19 PM

Document Has Been Signed on 09/20/2024 03:31 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 GOSS CENTERFACILITY NUMBER:
434406754
ADMINISTRATOR/
DIRECTOR:		KELLY ARANAFACILITY TYPE:
850
ADDRESS:2475 VAN WINKLE LANETELEPHONE:
(408) 353-0528
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 22TOTAL ENROLLED CHILDREN: 21CENSUS: 7DATE:
09/20/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Kelly AranaTIME VISIT/
INSPECTION COMPLETED:
04:00 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) Mel Matos met with Kelly Arana, Director, for an unannounced case management investigation in response to an Unusual Incident that the Facility self reported to the Department on September 10, 2024. LPA notes that the Facility is located on the campus of Goss Elementary School in one Portable facing Peter Pan Ave. The Facility operates a part time AM (8-11 AM) & PM (12-3 PM) session.

Kelly states that the Unusual Incident occurred on September 4, 2024 at approximately 11 AM. Kelly states that a parent of a preschool child left one of the entry/exit gates open during pick up time. Kelly states that parents come inside the playground to drop off and pick up their child(ren). Kelly states that she took three preschool children with her to the preschool playground to close the entry/exit gate. Kelly states that all other preschool children had already been picked up at the time of the incident. Kelly states that one of the preschool children that was with her saw the open gate and ran out of the gate towards the sidewalk area facing the playground. Kelly states that the preschool child was never "out of line of sight" and states that another preschool parent stopped the child on the sidewalk. Kelly states that the mother of the preschool child, who ran out of the gate, arrived at the same time and picked up her child & took the child home.

Kelly states that she spoke with the preschool child and the child's mother the following day and reminded them that any child(ren) cannot run out of the Facility or preschool playground unless accompanied by staff or an authorized parent/guardian. Kelly states that she also reminded staff and parents to ensure that the entry/exit gate is closed at all times, except for entry and exiting purposes. Kelly states that she also stationed one staff at the entry/exit gate during pick up and drop off times to ensure that the entry/exit gate is not left open.

Note: Kelly states that human resources conducted its own investigation of the incident and concluded that there was no evidence of any violation(s). A copy of the investigation findings were provided to LPA during today's investigation.

Based on interviews, record reviews, and evidence gathered during the investigation process, it is concluded there was no lapse in supervision since the child was not "out of line of sight". No deficiency(ies) issued as a result of today's investigation.

Exit interview conducted and report was reviewed with the Director, Kelly Arana. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2024
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 1