Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404854
Report Date: 08/11/2016
Date Signed 08/11/2016 03:41:16 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KIDANGO OHLONE CHYNOWETH CENTERFACILITY NUMBER:
434404854
ADMINISTRATOR:CONNIE LOMASFACILITY TYPE:
850
ADDRESS:5312 TERNER WAYTELEPHONE:
(408) 979-1670
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY:32CENSUS: 18DATE:
08/11/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Linda AguilarTIME COMPLETED:
03:00 PM
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Licensing Program Analyst, Pam Burkett, conducted an annual random visit. LPA met with qualified teacher, Linda Aguilar. Site Director, Virginia Fagundes is on vacation this week. LPA observed all the required posted materials.

LPA toured the facility both inside and outside. The day care is clean. Drinking water is readily available indoor with cups and water out of the faucet and outdoor via drinking fountain. Cleaning products are stored in a locked cabinet under the sink in the kitchen LPA observed trash cans with tight fitting lids for the disposal of solid waste. LPA reviewed five random children's files and two staff files.

The playground area is surrounded by appropriate fencing and the outdoor surfaces are safe. LPA observed spongy material as resilient material under the climbing structures. LPA did not observe any bodies of water. Linda stated there are no weapons. Bathroom was observed. One toilet is not working and the toilet seats are all very worn. Linda was advised to have toilet fixed and have new toilet seats installed. There is still enough toilets for the children enrolled. Linda stated they will never enroll more than 24 children. The facility is clean.

Food areas are clean and all food is stored at appropriate temperatures. The menus are posted. There is an appropriate fire extinguisher and smoke and carbon monoxide detectors. Sign in and sign out sheets were reviewed.

LPA reminded Linda on the requirements of AB 633, new car seat law, and healthy beverages in child care. LPA discussed the policy on Incidental Medical Services (IMS) with Linda. Medication was reviewed. There was no expired medication and all the medication is labeled with the child's name.

No deficiencies were cited during this visit.
NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Pam BurkettTELEPHONE: (408) 324-2111
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2016
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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