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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417059
Report Date: 08/08/2024
Date Signed: 08/09/2024 10:01:38 AM

Document Has Been Signed on 08/09/2024 10:01 AM - It Cannot Be Edited

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 CESAR CHAVEZ EARLY LEARNING CENTERFACILITY NUMBER:
434417059
ADMINISTRATOR/
DIRECTOR:		JOSEFINA GARCIA MARQUEZFACILITY TYPE:
850
ADDRESS:2000 KAMMERER AVENUETELEPHONE:
(408) 901-8296
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 96TOTAL ENROLLED CHILDREN: 72CENSUS: 48DATE:
08/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Josefina Garcia-CastilloTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Marilou Monico conducted a Case Management inspection in response to an incident that was reported by the facility to Licensing on August 5, 2024. LPA met with Site Director, Josefina Garcia-Castillo, and explained to her the purpose of today's inspection. LPA toured the facility, interviewed staff, and obtained copies of documents.

Based on interviews and available evidence, on August 2, 2024, at approximately 4 PM, a teacher (T1) brought the children from Room 197 to the bathroom leaving behind a child (C1) alone in the classroom. The bathroom is located adjacent to Room 197. Another staff (T2) found C1 in Room 197 unattended. The Site Director was notified of the incident by staff.

As a result of this inspection, Type A deficiency was cited on the following page.

Assembly Bill (AB) 633 was provided and discussed with Site Director. LPA informed the Site Director to provide a copy of this licensing report dated 08/08/24 that documents a Type A citation to parents/guardians of all children currently enrolled no later than the next business day or the next day the children are in care, and to parents/guardians of any newly enrolled children for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224) must be placed in the children's files for verification.

Exit interview conducted and report was reviewed with Site Director, Josefina Garcia-Castillo.

A Notice of Site Visit was issued and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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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Document Has Been Signed on 08/08/2024 03:48 PM - It Cannot Be Edited


Created By: Marilou Monico On 08/08/2024 at 03:01 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDANGO CESAR CHAVEZ EARLY LEARNING CENTER
FACILITY NUMBER: 434417059

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/09/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision - (a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Site Director states that an All Staff Meeting will be conducted on 08/09/24 at 2 PM and the importance of maintaining adequate supervision of children will be discussed. Meeting agenda and list of attendees to be sent to Licensing by 08/09/24.
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This requirement was not met as evidenced by: On 08/02/24, a child (C1) was left unattended in the classroom when a teacher (T1) brought the children to the bathroom. This poses an immediate risk to the health, safety, and personal rights of children in care.
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An immediate civil penalty of $500 was assessed.

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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:Joel Segura
LICENSING EVALUATOR NAME:Marilou Monico
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2024


LIC809 (FAS) - (06/04)
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