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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421333
Report Date: 02/07/2024
Date Signed: 02/07/2024 03:43:34 PM

Document Has Been Signed on 02/07/2024 03:43 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 - EMERALD VISTAFACILITY NUMBER:
013421333
ADMINISTRATOR:KUSHELYAD, VICTORIAFACILITY TYPE:
850
ADDRESS:6860 SOUTH MARIPOSA LANETELEPHONE:
(925) 336-3150
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 33DATE:
02/07/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Director, Victoria KushelyedTIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jyoti Saini met facility representative Victoria Kushelyed for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the staff. In addition to the director, 33 children and nine (9) staff members are present today. This facility currently operates three programs, 2 Part-Time programs Monday-Friday AM: 8:15-11:15, PM: 12:15-3:15 in room#125, and a Full Day program Monday-Friday 7:00 am-6:00 pm in room#126

The facility was inspected indoors and outdoors today for health and safety hazards, and the following was observed. No bodies of water, firearms, or weapons are on the premises. The Center is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. A first aid kit and a first aid backpack are available. The medications are stored along with the first aid kits. The outdoor play area is fenced for supervision. The play structure is age-appropriate and in good condition, with sufficient cushioning underneath. The children and staff have a separate bathroom. The bathrooms are safe, sanitary, and free of any hazardous items. There is drinking water readily available for children. The program provides daily snacks and lunch. Food is prepared and delivered by Kidango, Inc. The classrooms have appropriate postings. The last Emergency Drill was conducted on 01/31/2024 and is properly logged.
The menu is posted in a visible location and is dated for the entire month. All solid waste containers have tight-fitting covers and appear to be in good repair. The facility uses a kinder care app to sign the children in and out. LPA reviewed the sign-in and out sheet. There is a working fire alarm system at the facility. The room has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. All children have a record of emergency identification information and immunization records on file. The staff records reviewed were complete. All staff has a criminal record clearance on file. The site Director and staff have a current Pediatric First Aid/CPR certificate. All staff have taken Mandated Reporter training.

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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 02/07/2024 03:43 PM - It Cannot Be Edited


Created By: Jyoti Saini On 02/07/2024 at 02:54 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 - EMERALD VISTA
FACILITY NUMBER: 013421333

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(19)
Food Service
(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above.During the inspection, LPA observed expired food (snacks) in the kitchen which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 02/08/2024
Plan of Correction
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The Director immediately cleared and placed the expired foods in the trash bins.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


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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 - EMERALD VISTA
FACILITY NUMBER: 013421333
VISIT DATE: 02/07/2024
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During inspection,

Criminal Record Clearance -

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Lead Testing –


CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Incidental Medical Services (IMS)
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org
Facility representativew as informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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 - EMERALD VISTA
FACILITY NUMBER: 013421333
VISIT DATE: 02/07/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Type B deficiency and one (1) technical violation were given today.



A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Victoria Kushelyed
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
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