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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422494
Report Date: 02/06/2025
Date Signed: 02/06/2025 07:10:52 PM

Document Has Been Signed on 02/06/2025 07:10 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 ESTHER HOBBSFACILITY NUMBER:
013422494
ADMINISTRATOR/
DIRECTOR:		MAHBOOB ETEMADIFACILITY TYPE:
850
ADDRESS:4455 SENECA PARK AVENUETELEPHONE:
(510) 456-0881
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 21TOTAL ENROLLED CHILDREN: 21CENSUS: 19DATE:
02/06/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Mahboob EtemadiTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
NARRATIVE
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On February 6th, 2025 at approximately 10:15am, Licensing Program Analyst (LPA) April Wright conducted an unannounced Case management inspection regarding an Unusual Incident Report filed by the facility. LPA met with Center Director Mahboob Etemadi and toured the facility for a health and safety inspection. Incident occurred at the facilities preschool component. Present during the inspection 19 preschool age children and 4 fingerprint cleared staff personnel.

CCLD received an UIR dated 1/15/2025 which stated that C1 was observed by S3 to be "crying and screaming" in the playground across from the preschool classroom with S1. C1 was brought to the playground by S1 to calm down after not receiving anymore bananas at lunch time. Per S1, there were no more bananas to give C1 which caused them to become upset. S1 also stated that C1 was not having a good day and has daily "incidents" where they are "upset". While S1 was on the playground with C1, S3 observed S1 grab C1 by the left upper arm and calf and lift them from under the picnic table and place them on the grass nearby.

During the interviews, S1 demonstrated to LPA how they grabbed the C1 by the left arm and calf, lifting them up and moved the to the grass area of the playground. S3 also demonstrated how they observed S1 grabbed C1 from under the table by their left arm and calf, lifting up them to move hem to the grass area of the playground.

Based on admission, the Unusual Incident report and staff interviews that were conducted by the LPA, the facility is being cited for a violation of the child's Personal Rights.
See LIC809-D for deficiency page were CCR 101223 (a)(3) is being cited which must be corrected by a Plan of Correction.

Report was reviewed with the Center Director Mahboob Etemadi.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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 02/06/2025 07:10 PM - It Cannot Be Edited


Created By: April Wright On 02/06/2025 at 12:03 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 ESTHER HOBBS
FACILITY NUMBER: 013422494

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/11/2025
Section Cited
CCR
101223(a)(3)

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Personal Rights - 101223(a)(3) - To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Staff member will watch the "Personal Rights video in Child Care Centers" on the CCLD website. Center Director will have staff member write a statement to acknowledge the understanding of the video. Center Director will submit statement to LPA by 2/11/25.
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This requirement was not met as evidenced by: a staff member grabbed a child from under the table on the playground, lifting them by their left arm and calf, moving them to the grass area of the playground, which posed a potential risk to the health, safety, or personal rights to persons in care.
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Center Director will request internal training for staff member to ensure proper care and treatment of children with challenging behaviors as well as ensure children's personal rights are not violated.

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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: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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