<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421419
Report Date: 07/21/2023
Date Signed: 07/25/2023 01:19:07 PM


Document Has Been Signed on 07/25/2023 01:19 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:SAFARI KID - LIVERMOREFACILITY NUMBER:
013421419
ADMINISTRATOR:HAWKINS, JOYFACILITY TYPE:
850
ADDRESS:542 JUNCTION AVETELEPHONE:
(650) 384-9682
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:29CENSUS: 6DATE:
07/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Joy HawkinsTIME COMPLETED:
11:45 AM
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 July 20, 2023, Licensing Program Analyst (LPA) Simerjit Kaur arrived unannounced for a Required-1 Year inspection. LPA met with Facility Director Joy Hawkins. Upon initial arrival there was 2 preschool age children. During the inspection, 4 preschool age children and 1 aide Lavender Schoville arrived. The facility was toured for a health and safety inspection. The center is located in Torrid Apartments. Hours of operation are Monday through Friday, 6:30am to 6:30pm.

The preschool operates out of preschool classroom. All storage containers for solid waste have tight-fitting covers that are in good repair. The toilets and sinks were safe, sanitary and in operable condition. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the inspection. Furniture and equipment are in good condition, and floors are free of tripping hazards. The kitchen/food preparation and storage areas appear to be clean and free of evidence of rodents. Drinking water is available both indoors and outdoors. Menu is visible for public review. Medications are inaccessible to children. There are no pools or similar bodies of water at this facility. Outdoor activity space and climbing equipment is properly anchored to the ground and tan bark to absorb fall. Fire/Disaster Drills are conducted at least every six months, and a review of the log shows the last drill was conducted 5/11/23. Required licensing documents were posted. Fire alarm, fire extinguishers, and carbon monoxide meet the State Fire Marshall standards.



The facility is operating within its licensed capacity. LPA verified both opening and closing staff have current CPR/First aid training (expire on 8/15/23). Sign in/out logs are maintained. Children and staff records were reviewed, and contained required licensing documents. The facility director have current mandated reporter training (completed on 5/22/23). Staff have required immunization and mandated reporter training completed on 3/13/23.
Continued on LIC 809C
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Simerjit KaurTELEPHONE: (510) 622-2632
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SAFARI KID - LIVERMORE
FACILITY NUMBER: 013421419
VISIT DATE: 07/21/2023
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
Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $3000.00 maximum per day/per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Center Sections 101173 and 101226. 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, available at: http://www.ada.gov/childqanda.htm.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.



To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

See 809D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the director Joy Hawkins. Appeal rights provided

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Simerjit KaurTELEPHONE: (510) 622-2632
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 07/25/2023 01:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: SAFARI KID - LIVERMORE
FACILITY NUMBER: 013421419

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to persons in care. The facility does not have completed lead test.
POC Due Date: 08/21/2023
Plan of Correction
1
2
3
4
Director shall schedule lead testing and submit required documents (LIC 9275, LIC 9276, LIC 999, photos, lead testing results and any other supporting documents to LPA due date of 8/21/23.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to persons in care. Facility director does not have proof of Pertussis.
POC Due Date: 08/21/2023
Plan of Correction
1
2
3
4
Facility director shall provide proof of pertussis to LPA by 8/21/23.
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: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Simerjit KaurTELEPHONE: (510) 622-2632
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3