434414329-12-3-2019-07-CC-AALZ-BJHTNB-20191203135227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414329
Report Date: 12/03/2019
Date Signed: 12/03/2019 01:53:29 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-ALMADEN		FACILITY NUMBER:	434414329
ADMINISTRATOR:	NEENA BILLIMORIA		FACILITY TYPE:	850
ADDRESS:	6436 BOSE LANE		TELEPHONE:	(408) 600-6031
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95120
CAPACITY:	75	CENSUS:	DATE:	12/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:36 AM
MET WITH:			TIME COMPLETED:	01:57 PM

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An unannounced Annual Random Inspection was conducted on this day,by Licensing Program Analyst (LPA) Almaraz, Araceli. Facility is currently licensed for a capacity of 75. Licensing staff met with owner Chitkara, Jaishree. The program currently operates 7:00 AM to 6:30 PM, Monday thru Friday. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors. At the initial start of this visit, there was a total census of 20 children and a total census of five teachers/staff present, including owner and Director Billimoria, Neena.

PHYSICAL PLANT
This is a preschool program which consists of classrooms; Happy Helpers, Curious George. Jumpy Squirrel and Busy Bees. All areas identified on the Facility Sketch were inspected. The following was observed of classrooms and lavatories during inspection of this facility.

Happy Helpers: Upon arrival room had no teacher/staff and no preschool children present. Access to one sink and drinking water located inside classroom.

Curious George: Upon arrival room had no teacher/staff and no preschool children present. Access to one facet and drinking water located inside classroom.

Jumpy Squirrel: Upon arrival room had two teachers/staff and 20 preschool children present. Access to one sink and drinking water located inside classroom. Teacher and child ratios were observed and staff names recorded.

Busy Bees: Upon arrival room had no teachers/staff and no preschool children present. Access to one sink and drinking water located inside classroom. *****Page 1/5, Report Continued on Page 2*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAFARI KID-ALMADEN	FACILITY NUMBER: 434414329
	VISIT DATE: 12/03/2019

NARRATIVE

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LPA informed owner and Director to log onto web site www.ccld.ca.gov to obtain forms and LIVE SCAN application. Records for all children and staff must be maintained for three (3) years after separation from the facility.

LPA informed owner and director of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation. Director advised to visit www.shotsforschool.org for immunization information.

Director and owner advised that indoor and outdoor supervision required at all times. If outdoor area not adequately fenced, provider must be with children at all times when outdoors.

These forms may also be downloaded from our website: www.ccld.ca.gov

There was one type B deficiency cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1

Exit interview conductrd, copy of report was given. Appeal rights were issued and discussed.

NOTICE OF SITE VISIT ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

*****Page 5/5, Final Page of Report Continued from Page 4*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

Page: 3 of 6

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-ALMADEN	FACILITY NUMBER: 434414329
	VISIT DATE: 12/03/2019

NARRATIVE

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FACILITY RECORDS

Teacher-child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Electronic sign-in and out sheets and procedures were reviewed. . Personal Rights of children were observed by LPA.

Staff and Children’s Records were reviewed. Criminal Record Clearances were reviewed for adults.. Inspection of required forms made.

All individuals present have obtained a criminal record clearance or criminal recor exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. (All staff have received an active criminal record clearance as a condition of their employment.)

Children’s Records were reviewed for completeness; Inspection of required forms was made. LPA issued the Children’s Record Review (LIC 857) to owner during this inspection. In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

LPA also issued the Review of Staff records (LIC 859) to the licensee during this inspection. The LIC 857 and the LIC 859 documents the staff and children’s files that were reviewed during this inspection.

Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in. Disaster drill log was available, last drill was conducted on 11/18/2019.

Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Preschoolers bring their own food for AM/PM snacks and lunch. The facility provides AM and PM snacks if needed. *****Page 3/5, Report Continued on Page 4*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

Page: 4 of 6

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-ALMADEN	FACILITY NUMBER: 434414329
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/06/2020 Section Cited	1 2 3 4 5 6 7	Outdoor Actvity Space: (g)The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. This requirement was not met as evidenced by the fences provided are in sufficient condition and have areas the chidlren in care can fit in to the other side. This poses a potential risk to the health and safety of the children in care.
	1 2 3 4 5 6 7
	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: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

Page: 5 of 6

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-ALMADEN	FACILITY NUMBER: 434414329
	VISIT DATE: 12/03/2019

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

The following was discussed with the Owner and Director:

Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers, no Johnny Jumpers, no excersaucers or any other item that falls into that category are allowed in facility.

The inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA also provided a complete packet of the Provider Information Network (PIN) 10-02-CCP dated February 20, 2019 regarding Safe Sleep Awareness Campaign during today’s inspection.

The fire extinguishers 3A40BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. LPA Almaraz advised how to access forms and Regulations online at www.ccld.ca.gov. Director and owner made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. LPA Almaraz advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. LPA advised Director and owner that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. *****Page 4/5, Report Continued on Page 5*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

Page: 6 of 6

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-ALMADEN	FACILITY NUMBER: 434414329
	VISIT DATE: 12/03/2019

NARRATIVE

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Furniture and equipment were inspected for age appropriateness and are in sufficient condition. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Per owner, the isolation area is in the office. General sanitation was observed. Disinfectants, cleaning solutions, medication and other hazardous items that pose a risk to children, were inaccessible to the children in care. Owner Chitkara states that poisons are locked in the staff room closet. All areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable trash receptacles have tight-fitting covers that are kept on, and in standard condition. First Aid supplies were observed in the classrooms. According to owner Chirkara, medication is only administered to a child when accompanied with a doctor's note and is locked and stored in the office. Carbon monoxide detectors and smoke detectors are and working present in the facility. There are three Fire extinguishers size 3A40BC, last serviced on 03/20/2019 and inside or in close proximity to each classroom. Matts/cots inspected for appropriateness. children bring their own linens each Monday and take them home each Friday. Linens stores with children's belongings and separate from each other.

Lavatories: The are two lavatories in a centralized location labeled "boys" and "girls". Age appropriate sinks and toilets were inspected for availability and sufficient condition in all lavatories. LPA Almaraz observed age appropriate sinks and toilets and were inspected for availability, water temperature, toilet paper, area safety and sanitation. The Boys lavatory has a total of two toilets and two sinks. The girls lavatory has a total of three toilets and three sink. Both lavatories are available for the preschool children. There is a change table in the girls lavatory for children that may use diapers.. LPA Almaraz observed the children's sinks and toilets are in working condition and meet licensing standards. LPA Almaraz observed soap dispenser and disposable towels in the preschool lavatories. Staff has one separate lavatory that can be utilized by sick children if necessary. .

Outdoor playground equipment was observed. LPA Almaraz observed that the fences on the left and right side need to be repaired. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. *****Page 2/5 Report Continued on Page 3*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

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