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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422449
Report Date: 12/07/2023
Date Signed: 12/07/2023 11:25:58 AM

Document Has Been Signed on 12/07/2023 11:25 AM - It Cannot Be Edited

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 CASTLEMONT INFANTFACILITY NUMBER:
013422449
ADMINISTRATOR:JACKSON, BRANDIFACILITY TYPE:
830
ADDRESS:8601 MACARTHUR BLVD. BLD. 300TELEPHONE:
(510) 456-0876
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 14DATE:
12/07/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Brandi JacksonTIME COMPLETED:
11:30 AM
NARRATIVE
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On 12/7/23, at 8:45am, Licensing Program Analysts (LPAs) Catherine Fernandes and Janai McClain arrived on a case management inspection due to an incident report that was self reported to Community Care Licensing on 11/29/23. LPAs met with Director Brandi Jackson. Present in care on the infant side were 18 toddlers and six additional staff members.

The incident was called into the office on 11/29/23 and was not reported within the next business day which violates the reporting requirements. The incident occurred on 11/14/23, where a staff member strapped an infant into an adaptive chair during the entire lunch time and then during nap time the same child was held down by the same teacher using her leg. Based on the interviews and documents the center violated the child's personal rights.

LPAs Fernandes and McClain informed Director Jackson that this report dated 12/7/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risks to the health, safety, or personal rights of children in care. Also, LPAs Fernandes McClain informed the Director to provide a copy of this licensing report dated 12/7/23 that documents any Type A citations 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.

See 809D for citations

Exit interview conducted with Director

Appeal Rights, Report, LIC9224 and Notice of Site visit provided.

Notice of Site visit must be posted for 30 days.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2023
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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Document Has Been Signed on 12/07/2023 11:25 AM - It Cannot Be Edited


Created By: Catherine Fernandes On 12/07/2023 at 10:18 AM
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO CASTLEMONT INFANT
FACILITY NUMBER: 013422449

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/08/2023
Section Cited
CCR
101223(a)(1)

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Personal Rights- The licensee shall ensure that each child is accorded the following personal rights: To be accorded dignity in his/her personal relationships with staff and other persons. This requirement has not been met as evidenced by:
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Director is to review all Regulations 101223 (a) and watch the personal rights videos on the Community Care licensing website then send a statement of understanding to CCL by proof of correction date.
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Based on interviews and facility documents a child was held down by a staff member's leg during nap time which is an immediate risk to the personal rights of the children in care.
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Type A
12/08/2023
Section Cited
CCR101423.1(b)

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Infant Care Discipline- Confinement to cribs, high chairs, playpens or other similar furniture or equipment shall not be permitted as a form of discipline or punishment. This requirement has not been met as evidenced by:
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The center will schedule a staff training that includes who attended and the training agenda to CCL by proof of correction date.
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Based interviews and facility documents an infant was confined to a high chair during the lunch time which is an immediate risk to the safety of the 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.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/07/2023 11:25 AM - It Cannot Be Edited


Created By: Catherine Fernandes On 12/07/2023 at 10:50 AM
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDANGO CASTLEMONT INFANT
FACILITY NUMBER: 013422449

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/22/2023
Section Cited
CCR
101212(d)(1)

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Reporting Requirements- Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day..Any unusual incident or child absence that threatens the
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Director will watch the reporting requirements videos on the Community Care licensing website then send a statement of understanding to CCL by proof of correction date.
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 physical or emotional health or safety of any child. This requirement was not met as evidenced by: The center failed to follow reporting requirements which is a potential risk to the 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.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2023


LIC809 (FAS) - (06/04)
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