015700512-8-7-2020-52-CC-MOTI-BS9UAL-20200807152456

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700512
Report Date: 08/07/2020
Date Signed: 08/07/2020 03:25:09 PM

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 - IRVINGTON		FACILITY NUMBER:	015700512
ADMINISTRATOR:	KIRAN, GOWRI		FACILITY TYPE:	850
ADDRESS:	41811 BLACOW ROAD		TELEPHONE:	(408) 504-1965
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY:	120	CENSUS: 0	DATE:	08/07/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Gowri Kiran		TIME COMPLETED:	03:45 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	An announced Pre-Licensing Inspection was conducted today 8/7/2020 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant Gowri Kiran and Head of Operations, Aparna Parashar. The applicant has submitted an application for a brand new preschool license with up to 24 toddlers in the toddler option program. The program will operate from 7:00AM - 6:30PM, Monday through Friday, in 5 classrooms, a Multi Purpose Space, and Art Gallery (located in the hallway between Rooms 4 & 5). Classroom 2 & Classroom 5 will serve the toddler option program with up to 24 toddlers. A health and safety inspection was conducted inside and outside and the measurements are as follows: INDOORS: 3678.06 = 105 children OUTDOORS: 13262.89 square feet = 177 children The center has obtained an approved fire inspection clearance from the Fremont Fire Department on 7/23/20. A Heritage school is also on site, while some preschool children are also present. When the Heritage school is present at the same time with the preschoolers, the Heritage school will designate Classroom 1 & Classroom 2 as their room. The remaining rooms will be for preschool only, and allowing only the maximum of 74 preschoolers on site with the Heritage school. When Heritage school is not on site, the capacity increases to the maximum of 105 children. The preschool rooms are equipped with varied age appropriate materials and equipment. There are 8 toilets, 1 urinal and 11 sinks available for children. When the Heritage School is on site, the licensee will ensure there will be no commingling in the toilet area. The office and the staff toilet will serve as isolation areas for sick children.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2020

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 - IRVINGTON	FACILITY NUMBER: 015700512
	VISIT DATE: 08/07/2020

NARRATIVE

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The center was advised that there shall be no commingling between the preschool and Heritage school. The center will provide am/pm snacks with children bringing lunch from home. No cleaning agents were found stored with food. The center has pitchers and cups, as well as drinking fountains inside. Pitchers and cups will be taken to the play yard for outdoor activities with fountains available for use outside. First aid supplies are available in the center. There is a working telephone on site. Mats and Cots are being utilized. The play yard is fenced in all around. The small climbing structure is sufficiently cushioned with poured rubber. Sufficient shade was observed on the yard. Carbon monoxide detector was tested and is operable on today's date. The facility will utilize an electronic sign in/out system. With paper sign in/out as backup.
Individual Medical Services (IMS) policy was discussed. Facility provided LPA with current IMS plan. When any changes to IMS is made, an updated Plan of Operation 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.

Gowri Kiran is a fully qualified preschool director and has completed 16 hours of health and safety training including pediatric CPR and First Aid. Director is informed that Preventative health and safety training which includes lead component must be completed. Director is signed up for this course which will be taken on 8/26/2020.
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 provisional license for 105 preschool children, which includes up to 24 toddlers in the toddler option program, will be issued effective today 8/7/2020.

Applicant is to provide the following documentation within 90 days (11/07/2020) before a full license will be granted:
- Proof of Completion of Preventative Health & Safety Training which includes Lead Component
- Photographic proof of Multi Purpose Space & Art Gallery set up

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2020

LIC809 (FAS) - (06/04)

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