015700512-9-28-2023-52-CC-AWRT-CW4SRA-20230928140602

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700512
Report Date: 09/28/2023
Date Signed: 09/28/2023 02:06:13 PM

Document Has Been Signed on 09/28/2023 02:06 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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:	(510) 573-4871
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY: 105	TOTAL ENROLLED CHILDREN: 105	CENSUS: 74	DATE:	09/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Meenal Mehta		TIME COMPLETED:	02:10 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	On September 28th, 2023 at approximately 9:40am, Licensing Program Analyst (LPA) April Wright arrived for an unannounced Required-1 Year inspection, and met with Center director Meenal Mehta. Present today were seventy-four (74) preschool and toddler age children and ten (10) fingerprint cleared staff members present during the inspection. The facility is in ratio today. The facility was toured for a health and safety inspection. Hours of operation are Monday through Friday, 7:00am to 6:30pm. CLASSROOMS: Center has five (5) classrooms of which one is not in use at the time of inspection (Room 1). Classroom 2 - 5 were inspection. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting for safety and comfort. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is Room 1, away from other children in care. The center has smoke/carbon monoxide detectors, working telephone, and five (5) fully charged 3A40BC fire extinguishers in the facility. The center is equipped with fully stocked first aid kits and backpacks that is available in all classrooms. At least one person trained in CPR/First aid is present at the facility when children are present. BATHROOMS AND DIAPER CHANGING AREAS: The staff's bathroom is located in the hallway upon entry to the center and separate from the children's classrooms. All bathrooms are sanitary and in good condition. There a two (2) changing stations in the classrooms for toddler use. All sinks and faucets are in safe and sanitary operating condition. FOOD SERVICE AREAS: This facility provides AM/PM and lunch daily to children in care. There are weekly menus posted at the facility. All storage containers for solid waste have tight fitting covers that are in good repair Facility has a refrigerator which is clean and free of evidence of rodents, vermin or insects. See LIC 809C for continuance

Chandra Charles
April Wright
	DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - IRVINGTON	FACILITY NUMBER: 015700512
	VISIT DATE: 09/28/2023

NARRATIVE

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OUTDOOR PLAY AREAS: There are two (2) play structures with slide and two (2) playhouses that has grass and foam cushioning to absorb falls and that are anchored for stability. There's also a canopy area that provides shade to children while at play. There are no pools, hot tubs or other accessible bodies of water.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Ten (10) children's files and ten (10) staff files including directors file were reviewed. All staff files have required health screening and Employee Rights and all children files contain Identification & Emergency, Personal Rights, and Medical Consent forms. Children's files were missing California School Immunization Record (CDPH 286). LPA reviewed the facility roster and obtained a copy. Mandated Reporter Training and CPR/First Aid certificates were reviewed. S1 and S3 have not completed or expired Mandated Reporter training. The center is in compliance with the sign in and out procedure via Brightwheel. Disaster drills are being conducted every 6 months and the last one conducted was on 9/25/2023. All required documents are posted in a public accessible area. Per Director there are no weapons or firearms present at the facility.

Center Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP. PIN 22-05-CCP

See LIC809C continuance.

SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/28/2023 02:06 PM - It Cannot Be Edited

Created By: April Wright On 09/28/2023 at 01:10 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - IRVINGTON	FACILITY NUMBER: 015700512
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/28/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in S1 and S3 have expired or not completed Mandated Reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/06/2023
	Plan of Correction
1 2 3 4	Center Director will submit training certificates to LPA by due date listed above.

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that S5 does not have a TB clearance which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/09/2023
	Plan of Correction
1 2 3 4	Center Director stated that S5 has an appointment for TB test and will submit proof of completion and results to LPA by the due date listed.

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:

Chandra Charles

LICENSING EVALUATOR NAME:

April Wright

LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - IRVINGTON	FACILITY NUMBER: 015700512
	VISIT DATE: 09/28/2023

NARRATIVE

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LPA discussed the safe sleep regulations with Facility representative/ Director discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Deficiencies and Technical Violations Cited: Please see attached Deficiency & Advisory Note pages for additional information.

· Type B Violation (2) : Two staff members did not have proof of TB Clearance/ Two staff members did not have a current Mandated Reporter certification.

· Technical Violation: Children's files California School missing proof of immunization's - Immunization Record (CDPH 286)
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Center Director Meenal Mehta.

SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

LIC809 (FAS) - (06/04)

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