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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413043
Report Date: 01/06/2020
Date Signed: 01/06/2020 12:10:24 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SAFARI KID - SUNNYVALEFACILITY NUMBER:
434413043
ADMINISTRATOR:RAMAKRISHNAN, SUHASINIFACILITY TYPE:
850
ADDRESS:1271 WEST EL CAMINO REALTELEPHONE:
(650) 962-1366
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:100CENSUS: 59DATE:
01/06/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Suhasini RamakrishnanTIME COMPLETED:
12:15 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
Licensing Program Analyst (LPA) Tuoc Doan conducted an unannounced Annual inspection of the Preschool. LPA met with Director Suhasini Ramakrishnan and informed her of the purpose of the visit. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, and LIC613A Personal Rights were posted. The Preschool operates Monday - Friday, from 08:30 AM - 06:00 PM in Rooms 1, 2, 3, 4, and 5.
Preschool hours end at 12:00 PM in Room 1 because facility is using Room 1 for their Heritage Program from 12:00 PM - 06:00 PM. Facility has been granted the following waivers:
(1) to have a maximum capacity of 100 even though outdoor activity space only measures for 86 children.
(2) for the Heritage Program to use the Preschool playground at alternating schedule.
(3) for the children from the Heritage Program to pass through the Preschool Room 5 to get to their Room 1.

Facility was observed to be in compliance with teacher to child ratio requirement during inspection. LPA inspected the building inside and out. The five Preschool Classrooms, children and staff restrooms, maintenance/utility storage area, Staff room, and Office area were inspected. The facility has one upstairs room where daycare is not permitted per Fire Clearance.

Outdoor activity space was fenced. LPA observed play equipment were maintained in good condition. Areas around and under high climbing equipment were cushioned with material that absorbs falls. Drinking water is arranged to be readily available for children in care. Shade is provided by trees, building overhang, etc. There were no bodies of water observed. Director stated that facility does not have weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Restroom for children to use were observed to be in operating conditions. Floors were clean.
First Aid Kit was inspected. LPA observed facility has fully charged fire extinguishers last serviced in 01/2019, and smoke and carbon monoxide detectors. Facility has a Fire Prevention & Hazardous Material Consolidated Permit for "Fire Code Regulated Operation." The permit expires on 01/10/2023. Last fire and lock down drills were practiced on 09/17/19 and Earthquake drill was practiced on 08/05/19.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAFARI KID - SUNNYVALE
FACILITY NUMBER: 434413043
VISIT DATE: 01/06/2020
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
Facility contracts with a third party vendor, "Freya Food Inc." to provide Lunch and PM snack. Menu was posted. Trash cans for solid waste had tight fitting lid.

LPA reviewed facility's electronic sign in and out record and procedure named "Sandbox" with Director. A sampling of children and staff files was taken for review during today's inspection. Children records reviewed include Admission Agreement, Identification and Emergency Contact Information, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, and Medical Assessment, Immunization.

Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Education Qualification, Health Screening Report with TB Clearance, Immunization (Measles and Pertussis) record and required Training. LPA reminded Director that the AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one staff with current certification in Pediatric CPR and First Aid present at the facility. Director stated facility is not providing transportation to children.

LPA reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

LPA also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov
[Shortcut: ccld.ca.gov] to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAFARI KID - SUNNYVALE
FACILITY NUMBER: 434413043
VISIT DATE: 01/06/2020
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
This facility provides Incidental Medical Services – IMS. Director stated that currently there are no children in care who requires IMS. 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.

In the areas that were evaluated, regulatory violations were observed at the time of the visit. Exit interview was conducted, where this report, the violations, plan of corrections, and appeal rights were reviewed with Director.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAFARI KID - SUNNYVALE
FACILITY NUMBER: 434413043
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/06/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/10/2020
Section Cited

1
2
3
4
5
6
7
SIGN IN AND OUT. The person who brings the child to, and removes the child from, the center shall sign the child in/out.
This requirement is not met as evidenced by:
Based on LPA's audit of Sign In/Out record for two days in in the week of 12/16 - 12/20/2020,
there were 12 children who were not signed
8
9
10
11
12
13
14
 out. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
Type B
01/27/2020
Section Cited

1
2
3
4
5
6
7
HEALTH & SAFETY CODE. Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. [...] The day care center shall maintain documentation of the required immunizations.
8
9
10
11
12
13
14
This requirement is not met as evidenced by: Per LPA's review of files during the inspection, Licensee failed to maintain documented proof that staff Guadalupe Rodriguez, Sonia Vohra, and Debasmita Ghosh are immunizated against Measles and/or Perutssis. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
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: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:
DATE: 01/06/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/06/2020
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAFARI KID - SUNNYVALE
FACILITY NUMBER: 434413043
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/06/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/20/2020
Section Cited

1
2
3
4
5
6
7
MANDATED REPORTER TRAINING. [...] a person who, on January 1, 2018, is a licensed child care provider [...] shall complete the mandated reporter training provided [...] and shall complete renewal mandated reporter training every two years [...].
This requirement is not met as evidenced by:
8
9
10
11
12
13
14
Per LPA's review of record, staff Sonia Vohra, Debasmita Ghosh, and Debolina Mitra have not completed the required AB1207 Mandated Reporter Training. This poses a potential risk to children's health and safety of children in care.
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: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:
DATE: 01/06/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/06/2020
LIC809 (FAS) - (06/04)
Page: 5 of 5