Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416125
Report Date: 12/05/2018
Date Signed: 12/05/2018 04:07:55 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDANGO-GUY EMANUELEFACILITY NUMBER:
013416125
ADMINISTRATOR:SAGGI, RENUFACILITY TYPE:
850
ADDRESS:100 DECOTO ROADTELEPHONE:
(510) 471-2461
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:21CENSUS: 17DATE:
12/05/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Balbina RodriguezTIME COMPLETED:
04:25 PM
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Licensing Program Analyst (LPA) Briana Plumboy met today with Center Director Balbina Rodriguez for an ANNUAL RANDOM INSPECTION. Also present for the inspection were 1 fingerprint cleared staff, 1 parent volunteer, as well as 17 preschool children in care. The center is located on the Guy Emanuele Elementary School Campus inside room 5. LPA toured the facility and play yard for a health and safety inspection. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. (2) Personnel files were reviewed. The teacher/child ratio was being met. The sign in/out was reviewed and matched the physical census of the children. The classroom and play yard were age appropriate and in good repair during today's inspection. Bathrooms were clean and in working order during the inspection. The trash cans have tight fitting lids. Meals are prepared and delivered by Kidango, Inc. There is a menu posted for the entire month. The kitchen area was maintained during the inspection. There is water readily available. The program consists of two 1/2 day sessions; napping equipment is not needed. All posting requirements are being met. The outdoor play area surface is not being maintained. There is shaded area for the children and access to drinking water. The center has a waiver for the outdoor play area. Medications are dispensed at this facility. The center has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, pull down fire alarm, and First Aid Kit. All staff have current CPR and first aid training. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 11/03/18.
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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
The facility has and is implementing their IMS Plan. Medication was reviewed by LPA.
See 809-C for continuance
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: 510-286-4356
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2018
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDANGO-GUY EMANUELE
FACILITY NUMBER: 013416125
VISIT DATE: 12/05/2018
NARRATIVE
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California Law requires Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

The licensee is reminded any structural changes to the center or additions to the child care facility must be reported to Community Care Licensing.

Licensee is reminded that ALL Staff must be fingerprint cleared prior to being in the presence of children in care, or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.



For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

See 809-D for deficiency cited today. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: 510-286-4356
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2018
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KIDANGO-GUY EMANUELE
FACILITY NUMBER: 013416125
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/18/2018
Section Cited
CCR
101238.2(d)
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Outdoor Activity Space. The surface of outdoor activity space shall be maintained in safe condition.THIS IS BASED ON A TOUR AND INSPECTION OF THE YARD. THE CUSHIONING OF THE YARD UNDERNEATH THE PLAY STRUCTURE HAS CRACKS IN MULTIPLE LOCATIONS AND HAS MISSING
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On or before 12/18/18, the Director will develope a plan to maintain the cushioning under the play structure and around the playstructure. Director will submit to LPA Plumboy a plan of action either via fax, email, or post.
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MATERIAL IN MULTIPLE LOCATIONS. THE PLAYGROUND SURFACE IS NOT LEVEL WITH THE CEMENT WHICH POSES AS A HAZARD. THE CENTER HAS A WAIVER AND SHARES THE OUTDOOR ACTIVITY SPACE. BY THE OUTDOOR ACTIVITY SPACE NOT BEING MAINTAIN, IT POSES A POTENTIAL RISK TO CHILDREN IN CARE.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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: Diane PerezTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: 510-286-4356
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2018
LIC809 (FAS) - (06/04)
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