Kidango - Carlson Center

including a copy of the Active supervision meeting held on 10/31/25, employee write-up documentation, 8 9 10 11 12 13 14 This requirement was not met as evidenced by: During a transition from the yard to lunch a child was left outside unsupervised for approximately 10-15 minutes which poses an immediate risk to the health and safety of persons in care. 8 9 10 11 12 13 14 revised Supervision Plan, and contracts for supervision of children signed by staff. The deficiency is corrected today. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Wynn Norona NAME OF LICENSING PROGRAM MANAGER: Diana Campos NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/03/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2025 LIC809 (FAS) - (06/04) Page: 3 of 3

(POC) due date, may result in a civil penalty assessment.