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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434406759
Report Date: 04/02/2025
Date Signed: 04/02/2025 12:24:05 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/26/2025 and conducted by Evaluator Syhshyan Yu
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250226081724
FACILITY NAME:KIDANGO LINDA VISTAFACILITY NUMBER:
434406759
ADMINISTRATOR:STEPHANIE LOPEZFACILITY TYPE:
850
ADDRESS:65 GORDON AVENUETELEPHONE:
(408) 353-0677
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY:40CENSUS: 21DATE:
04/02/2025
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Vicki GonzalesTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff do not ensure adequate care and supervision is provided to children
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Shine Yu and Jennifer Beehler conducted a continued complaint investigation. LPAs met with Vicki Gonzales, Center Director for the school age program and explained to her the nature of today's visit. LPAs interviewed staff, observed the classroom, observed outdoor activity play, obtained pertinent documents and reviewed files.

During the investigation, it was determined through confidential interviews that staff
did not provide 100% supervision of children in care which resulted in an unexplained injury of a child. The preponderance of evidence standards has been met, therefore the above allegation is found to be SUBSTANTIATED.

Due to today's investigation, One Type B Deficiency was cited, more information provided on the attached LIC9099-D. Exit interview conducted with Vicki Gonzales and report was reviewed and provided, along with appeal rights.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 07-CC-20250226081724
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 LINDA VISTA
FACILITY NUMBER: 434406759
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/02/2025
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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Facility management provides training the substitute teacher and all staff in relation to supervision. Facilty will email proof of training to LPA by 4/11/2025. Facility will provide a supervison plan to all ELSA teachers prior to employment.
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This requirement has not been met as evidenced by: Staff did not have 100% visual supervision of children in care which resulted in an unexplained injury for a child. This poses a potential health and safety risk to children in care.
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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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2