414004526-12-11-2019-05-CC-CINO-BJRQS2-20191211112450

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004526
Report Date: 12/11/2019
Date Signed: 12/11/2019 11:24:54 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SAFARI KID MENLO PARK		FACILITY NUMBER:	414004526
ADMINISTRATOR:	COLUZZI, BEVERLY		FACILITY TYPE:	850
ADDRESS:	107 CLOVER LANE		TELEPHONE:	(650) 322-0192
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY:	24	CENSUS: 14	DATE:	12/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Owner, Sandhya Menon		TIME 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	Licensing Program Analyst (LPA), Cindy Interiano, conducted an Annual/Random inspection and met with Owner, Sandhya Menon and Site Supervisor/Head Teacher, Beverly Coluzzi. Purpose of the inspection was explained. Program operates in one large classroom, and a small classroom towards the back of the building. Kitchen and Staff restroom are maintained off limit to children. Program operates M-F, 7:30a-5:30p, year-round with periodic breaks throughout the year. Present during the inspection was Owner and Head Teacher supervising 14 PreK children. Program is in compliance with Staff:Child ratios. LPA and Owner inspected facility indoors and outdoors for Health and Safety Hazards. Classrooms have age appropriate toys and equipment. Cubbies and hooks are used to store children’s belongings. Large classroom is equipped with a restroom with 2 toilets and 2 sinks. Restroom is kept clean, in good repair, and maintained with adequate supplies. Furnace is properly covered. Napping equipment is properly stored in the classroom. Program provides daily snacks and children bring their own meals. Classroom has a fully supplied Emergency Kit and Emergency Supplies, which are maintained inaccessible to children. Classroom has a working telephone, multiple smoke and carbon monoxide detectors, and fire extinguishers. Last emergency drill was conducted on 10/17/19 and is properly logged. Discipline policy is mainly redirection. Outdoor play area is completely fenced. Outdoor play area is kept clean and free of debris and hazardous items. Sand box is covered daily. Staff conduct a daily sweep prior to the children going out for outdoor play. All outdoor toys and equipment are age appropriate and in good repair. Drinking water is readily available outdoors and indoors. All mandatory postings are posted near the main entrance of the facility. Sign in/out sheet was reviewed and was complete and up-to-date. Staff and Children's files were reviewed and are complete and up-to-date. See Page 2. . .

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SAFARI KID MENLO PARK	FACILITY NUMBER: 414004526
	VISIT DATE: 12/11/2019

NARRATIVE

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Page 2. . .

During the inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Owner was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Owner was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare.
*Owner was reminded about Mandated Reporter Training available on CCLD website
(www.ccld.ca.gov or www.mandatedreporterca.com)
*Owner was advised of the new Lead Bill (effective 01/01/19), requiring Facilities to distribute a two-page flyer to Guardians with information on lead poisoning facts
*Owner was reminded about the Provider Information Notices (PINs) on CCLD website.

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

>This report and rights to comment and appeal were discussed with Owner. This report must be available in the facility for public review. Notice of site inspection was posted.
Owner was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019

LIC809 (FAS) - (06/04)

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