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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407477
Report Date: 11/18/2019
Date Signed: 11/18/2019 11:12:13 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SAFARI KID - WALNUT CREEKFACILITY NUMBER:
073407477
ADMINISTRATOR:NOURA HALABIFACILITY TYPE:
850
ADDRESS:2074 TREAT BLVD.TELEPHONE:
(925) 295-0761
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:84CENSUS: 40DATE:
11/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Ms. Elahmadli & Ms. HalabiTIME COMPLETED:
11:30 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
3 LPA, Hollie met with Assistant Director, Ms. Elahmadi at the start of the visit and shortly after, the Director Ms. Halabi, for the purpose of a Random Health and Safety Inspection. Present during this visit are six staff and a total of 40 children in care. A tour of the facility was conducted. There are no bodies of water or fire arms on the premises, per the Director. During this visit, all children were under visual supervision of staff. The facility is within ratio with one teacher supervising no more than 12 children. Disinfectants, cleaning solutions, poisons and other dangerous items are inaccessible to children during this visit. Poisons are locked. Medications are inaccessible to children. All toilets and sinks are operable and sanitary with sufficient soap and paper products. Floors are free of tripping hazards. Furniture and equipment are age appropriate and appear to be in good condition and free from sharp, loose or pointed parts. The kitchen/food preparation area is free of litter, rubbish and the evidence of rodents or vermin. SEE NEXT PAGE FOR CONTINUED REPORT
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
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 5
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAFARI KID - WALNUT CREEK
FACILITY NUMBER: 073407477
VISIT DATE: 11/18/2019
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
Food, including snack is brought from home, per the licensee. The facility has snack in case is not brought to the center. Solid waste storage vessels (garbage cans) including moveable bins, have tight-fitting covers on and are in good repair. Uncontaminated drinking water is available both indoors and outdoors. All foods/beverages that are capable of rapid spoiling are properly stored. The facility has a carbon monoxide detector that meets statutory requirements. All required forms are posted. The outdoor activity space was toured and appears to be in safe condition, absent of sharp, loose or pointed items that would cause hazards. Playground equipment appears to be in good condition, free of sharp, loose or pointed parts. One of the plastic play structures, appears to be wearing do to the sun. The Director stated that she would pay close attention for further wear. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility remains fenced. The facility is operating within its licensed capacity. The opening and closing staff have current CPR/First Aid. LPA reviewed a sampling of children’s records for admission accuracy. The sign in and sign out/electronic/manual was reviewed for legal signatures. SEE NEXT PAGE FOR CONTINUED REPORT
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAFARI KID - WALNUT CREEK
FACILITY NUMBER: 073407477
VISIT DATE: 11/18/2019
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
The Licensee was informed that all person’s 18 years of age or older, who are employed at the facility, must obtain a fingerprint clearance or a fingerprint cleared association, PRIOR to being in the presence of children. Staff records were reviewed for education qualifications and fingerprints.

THE LICENSEE WAS INFORMED THAT IF THE FACILITY RECEIVES A DEFICIENCY, THE PLAN OF CORRECTION MUST BE CORRECTED BY THE DATE PROVIDED OR A CIVIL PENALTY OF $100 PER DAY WILL BE ASSESSED TO THE FACILITY UNTIL THE DEFICIENCY IS CORRECTED. ADDITIONALLY, A REPEAT VIOLATION OF A DEFICIENCY WILL BE ASSESSED IN THE AMOUNT OF $250 AND $100 PER DAY UNTIL CORRECTED.

LPA DISCUSSED WITH LICENSEE THAT AS OF SEPTEMBER 1, 2016, ANY PERSON(S) EMPLOYED OR VOLUNTEERING AT A CHILD CARE CENTER SHALL BE IMMUNIZED AGAINST INFLUENZA(optional), PERTUSSIS AND MEASLES OR MUST QUALIFY FOR AN EXEMPTION,

LPA encouraged the Licensee to review our website at the above address at CCLD.CA.GOV to stay up to date and informed on Laws and Title 22 Regulations as it relates to Child day care business, particularly the Provider Information Notices, known as PINS.



See next page for continued report
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAFARI KID - WALNUT CREEK
FACILITY NUMBER: 073407477
VISIT DATE: 11/18/2019
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
LPA informed Licensee regarding the new Law requiring Child Care Centers and Family Day care Homes to obtain Mandated Child Abuse Reporting Training, (Assembly Bill 1207). 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.

DURING THIS VISIT, LPA NOTED THAT MEDICATION IS EXPIRED FOR A CHILD THAT REQUIRES INCIDENTAL MEDICAL SERVICES. PLEASE SEE 809-D FOR TYPE B DEFICIENCY

THE LICENSEE WAS PROVIDED A COPY OF THEIR APPEAL RIGHTS (LIC 9058 12/15) AND THEIR SIGNATURE ON THIS FORM ACKNOWLEDGES RECEIPT OF THESE RIGHTS. LPA POSTED THE REQUIRED POSTINGS FOR PUBLIC VIEWING

see 809-d for type b deficiency notice.

SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - WALNUT CREEK
FACILITY NUMBER: 073407477
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/29/2019
Section Cited

1
2
3
4
5
6
7
HEALTH RELATED SERVICES 101226 (e) In centers where the licensee chooses to handle medications: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. THIS REQUIREMENT IS NOT BEING MET.
8
9
10
11
12
13
14
There is a child in care, who's prescription is expired in 2018, therefore, if need the medication could not be administered as prescribed by physician. Thus making this a Potential hazard.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 11/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/18/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5