013423038-5-5-2022-52-CC-JSAI-CE5S4S-20220505133314

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423038
Report Date: 05/05/2022
Date Signed: 05/05/2022 01:33:38 PM

Document Has Been Signed on 05/05/2022 01:33 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SAFARI KID UNION CITY		FACILITY NUMBER:	013423038
ADMINISTRATOR:	TARUNKUMAR, DEEPA		FACILITY TYPE:	850
ADDRESS:	32462 ALVARADO BLVD		TELEPHONE:	(510) 386-7777
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY:	79	CENSUS: 41	DATE:	05/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Staff, Shoba John and Director Deepa TarunKumar		TIME COMPLETED:	02:15 PM

NARRATIVE

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Licensing Program Analyst (LPA) Jyoti Saini met with Teacher Shoba John for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the staff. The Director, Deepa Tarunkumar arrived during the inspection. In addition to the director, there are 40 children and 7 staff present today. The facility operates Monday - Friday from 8:00 AM to 6:00 PM. The facility was inspected indoor and outdoor today for health and safety hazards and the following was observed; There are no bodies of water, firearms, or weapons on the premises. The center is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. A first aid kit and a first aid backpack are available. The outdoor play area is fenced for supervision. The play structure is age-appropriate and in good condition with sufficient cushioning underneath. There are 3 bathrooms with 2 toilets and 1 sinks in each. The staff has separate bathroom. The bathrooms appear to be safe, sanitary, and free of any hazardous items. There is drinking water readily available for children. The children bring their lunch and snacks. The classroom has appropriate postings. The last Emergency Drill was conducted on 04/26/2022 and is properly logged.

LPA reviewed sign-in and out sheet. The center has a complete record of sign-in/out sheets by an authorized pick up person. There are multiple first aid kits available. There is a working fire alarm system in the facility. The Facility has a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available.

All the Children records reviewed were complete. All children have a record of emergency identification information on file. All staff has a criminal record clearance on file. The site Director has a current Pediatric First Aid/CPR certificate on file. All staff has taken Mandated Reporter training. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site always or present during off-site activities (field trips). The opening teacher of the facility has expired CPR since 08/2021.Facility roster was obtained.

See next page...

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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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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 UNION CITY	FACILITY NUMBER: 013423038
	VISIT DATE: 05/05/2022

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During inspection,

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 $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS (Incidental Medical Services) to children currently. If any IMS is provided, a 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, available at: http://www.ada.gov/childqanda.htm

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 809-D for deficiency cited today.

A notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report was reviewed with the director, Deepa TarunKumar

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/05/2022 01:33 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID UNION CITY	FACILITY NUMBER: 013423038
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, Interview, and record review, the licensee did not comply with the section cited above. S7, the opening teacher, does not have valid CPR on the file which poses a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/26/2022
	Plan of Correction
1 2 3 4	S7 has enrolled herself for the next available CPR/1st Aid training class.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

LIC809 (FAS) - (06/04)

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