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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416837
Report Date: 08/01/2024
Date Signed: 08/01/2024 01:31:50 PM

Document Has Been Signed on 08/01/2024 01:31 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDANGO - WASHINGTON HOSPITAL CENTERFACILITY NUMBER:
013416837
ADMINISTRATOR/
DIRECTOR:		GUADALUPE LARA-CEJAFACILITY TYPE:
830
ADDRESS:2500 MOWRY AVENUETELEPHONE:
(510) 996-5738
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 17DATE:
08/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Guadalupe Lara-CejaTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
NARRATIVE
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On August 1st, 2024 at approximately 10:30am, Licensing Program Analyst (LPA) April Wright met with Center Director Guadalupe Lara-Ceja for a Case Management visit. Present were 17 infant/toddler age children and 5 fingerprint cleared staff personnel. The purpose of the visit was to follow up on 2 unusual incident reports received and submitted by the facility regarding a child being left unsupervised.

On 7/17/2024, C1 was left unattended on the playground unsupervised during the lunch time transition to the classroom. S2, S3 and S4 noticed the child was not in the classroom seated at the lunch table. S2 retuned to the yard to see C1 laying down in the bungalow area. C1 was brought back to the classroom by S2 and parents were notified of the incident. Center Director was attending an Directors meeting and was offsite when this incident occurred, was notified the following day.

On 7/30/2024 during the transition from the play yard to the classroom for lunch, C1 was again left in play yard in the bungalow area. S2, S3 and S5 noticed the child was not present at the table after the transition. Per incident report,"the teachers noticed during this transition after getting settling in for lunch, that a child had been left behind."S2 found the C1 again in the bungalow laying down and brought C1 back to the classroom. Regional Director was notified of the incident due to S1 being on vacation at the time when the incident occurred. Parents were notified of the incident and teachers were placed on administrative leave pending an investigation from Human Resources.

Due to the lack of supervision during these incidents, the facility is being issued a Type A Violation and a $500.00 immediate civil penalty is also being assessed. LPA informed Center Director that this report dated 8/1/2024, which documents the Type A citation shall be posted for 30 consecutive days. This violation posed an immediate risk to the health, safety, and personal rights of children in care.

See LIC 809C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDANGO - WASHINGTON HOSPITAL CENTER
FACILITY NUMBER: 013416837
VISIT DATE: 08/01/2024
NARRATIVE
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LPA also informed the center director to provide a copy of this licensing report dated 8/1/2024 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Notice of site visit was given and must remain posted for 30 days. Report read and appeal rights given to Center Director Guadalupe Lara-Ceja.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/01/2024 01:31 PM - It Cannot Be Edited


Created By: April Wright On 08/01/2024 at 12:19 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
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO - WASHINGTON HOSPITAL CENTER
FACILITY NUMBER: 013416837

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/02/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1) - 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,
This was evidenced by:
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Center Director met with staff on 7/30/2024 and has training's planned to remind staff of their duties and responsibilities of supervising children. Regional Manager has training's planned and weekly scheduled for the staff in question.
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Based on interviews and admission, the center did not comply with the section cited above in which child was left unsupervised during lunch transition twice within a 2 week period, which poses an immediate health, safety or personal rights risk to children in care. A zero tolerance deficiency is being issued
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Center Director will provide proof to LPA on 8/2/2024 that trainings and weekly check in have been scheduled.

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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:Chandra Charles
LICENSING EVALUATOR NAME:April Wright
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024


LIC809 (FAS) - (06/04)
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