013421419-7-20-2021-52-CC-JMIR-C54PY7-20210720114328

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421419
Report Date: 07/20/2021
Date Signed: 07/20/2021 11:43:37 AM

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SAFARI KID - LIVERMORE		FACILITY NUMBER:	013421419
ADMINISTRATOR:	HAWKINS, JOY		FACILITY TYPE:	850
ADDRESS:	542 JUNCTION AVE		TELEPHONE:	(650) 384-9682
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94551
CAPACITY:	29	CENSUS:	DATE:	07/20/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Joy Hawkins		TIME COMPLETED:	12:00 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On 07/20/2021 Licensing Program Analysts (LPAs) Jaylena Miller and Jabari Wilson conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION. LPAs met with facility director, Joy Hawkins and the facility was toured to conduct a Health and Safety Inspection. Also present at the time of this inspection was 1 staff and 11 children. The facility is within ratio and capacity compliance today. This program operates out of preschool classroom. All classrooms were inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPAs observed the cleanliness of floors and surfaces, the presence of working carbon monoxide detector, smoke detectors/fire alarms and a fully charged fire extinguisher size 2A10BC that is accessible. The bathrooms have age appropriate faucets and toilets in working condition. The outdoor play area is fully fenced. There is padding under/around the climbing equipment. The play structures appear to be age appropriate for children; LPA did notice one defect on the play structure that LPA pointed out to director and fixed it immediately by taping it off. LPA also pointed out the boarder board of the tanbark that is currently knocked down and needs repair, per director it was already noted, and a maintenance ticket is open for it to be repaired. There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children. All required postings are present. The facility serves breakfast, lunch and snacks, menu is also posted. LPA reviewed storage of food, medication and medical equipment/supplies and is inaccessible to the children. Per director, there are no firearms present on the premises.

A copy of the facility personnel roster and children’s roster was obtained. LPA reviewed the file of 11 children enrolled in the program and 2 staff members files, who are fingerprint cleared, completion of Mandated Reporter training as well as proof of immunization's. Director does have CPR/First Aid certificates that expire 12/1/2020 however proof of scheduled class for 8/15/2021 was verified, and proof of education and/or experience was also present. The center also conducts and documents fire and earthquake drills once every 6 months and the logs show that drills were conducted on 7/7/2021.

Please see LIC 809-C for continuation

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena Miller	TELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - LIVERMORE	FACILITY NUMBER: 013421419
	VISIT DATE: 07/20/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPAs also discussed with the Director that ALL assistants. Volunteers, frequent visitors, over the age of 18, must be fingerprint cleared and associated prior to being in the presence of children in care. An immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Director was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years. LPA also encouraged the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded.

Individual Medical Services (IMS) policy was discussed. The Director is reminded that when any changes to the IMS plan is made, an updated Plan for Providing IMS must be submitted to the Department.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care centers and the ADA website at: http://www.ada.gov/childganda.htm.

For licensing updates, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

Effective August 1, 2003 California Law requires Child Care licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury for (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

There are no deficiencies cited today. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with Director.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena Miller	TELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2