015700508-12-13-2019-52-CC-MMEA-BJTR32-20191213113914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700508
Report Date: 12/13/2019
Date Signed: 12/13/2019 11:39:24 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 - PLEASANTON		FACILITY NUMBER:	015700508
ADMINISTRATOR:	NACHIAPPAN, LAKSHMI		FACILITY TYPE:	850
ADDRESS:	4464 WILLOW ROAD, SUITE 101		TELEPHONE:	(510) 541-7264
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY:	105	CENSUS: 0	DATE:	12/13/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Lakshmi Nachiappan, Nachiappan Periakaruppan, Auxilia William		TIME COMPLETED:	11:50 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	A Prelicensing Visit was conducted today 12/13/19 by Licensing Program Analysts (LPAs) Mayla Mendoza and Jonathan Williams. LPAs met with Owner/Director, Lakshmi Nachiappan, Principal Nachiappan Periakaruppan and Vice President Auxilia William. The applicant has submitted an application for a brand new preschool license. The program will operate from 8:00am-6:30 PM in one building. A health and safety inspection was conducted inside and outside and the measurements are as follows: INDOORS: 4968.448 square feet = 141 children OUTDOORS: 5038.31 square feet = 67 children The center has obtained an approved fire inspection clearance from the Livermore-Pleasanton Fire Department on 12/2/19. Program also has a Heritage School on site. Center is reminded to never commingle the preschool children with the Heritage School. The preschool rooms are equipped with varied age appropriate materials and equipment. There are 8 toilets and 8 sinks available for children. The art room and the staff bathroom will serve as isolation areas for sick children. The play yard is fenced in all around. The small climbing structure is sufficiently cushioned by artificial turf. Trees provide sufficient shade in the play yard. The center will also be using the gross motor room as additional play yard space. The center has jugs and cups for both indoors and outdoor activities. The center was advised to request for a Waiver for the outside play area which can only allow for 67 children at a time. The center will provide am/pm snacks. No cleaning agents were found stored with food. First aid supplies are available in the center. There is a working telephone on site. Carbon monoxide is available. The sign in/out sheets provide for a full signature.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

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 - PLEASANTON	FACILITY NUMBER: 015700508
	VISIT DATE: 12/13/2019

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. A Plan of Operation that includes 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.

Lakshmi Nachiappan is a fully-qualified preschool director and will have completed 16 hours of health and safety training including pediatric CPR and First Aid.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair.

A license for 105 preschool children will be issued effective today 12/13/19.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

LIC809 (FAS) - (06/04)

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