Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416125
Report Date: 04/23/2021
Date Signed: 04/23/2021 02:44:49 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDANGO-GUY EMANUELEFACILITY NUMBER:
013416125
ADMINISTRATOR:SAGGI, RENUFACILITY TYPE:
850
ADDRESS:100 DECOTO ROADTELEPHONE:
(510) 675-7103
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:36CENSUS: 7DATE:
04/23/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Renu SaggiTIME COMPLETED:
02:50 PM
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On 04/23/2021 at 1:45pm, Licensing Program Analyst (LPA) Jonathan Williams met with facility Director, Renu Saggi, for an unannounced case management inspection. Present for today's inspection were five fingerprint cleared and associated staff and seven preschool age children in care.

The facility has installed a play structure in the outdoor play area. The structure was observed at 2:05pm to have poured rubber underneath it to cushion falls and LPA observed the structure to be firmly anchored to the ground throughout the inspection. LPA observed the structure to be barricaded to prevent access to children at this time.

LPA reminded the Director at 2:30pm that all further additions or changes to the facility, including outdoor play structures, must be approved by the Department before use by children. LPA reminded the Director at 2:30pm that all play structures must be age-appropriate and kept in working order at all times.

Play structure is approved for use by children pending submission of documentation indicating age-appropriateness.

There are no deficiencies cited today. This report shall remain on file for 3 years. Appeal Rights provided. Exit interview conducted at 2:34pm.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021
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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