015700591-1-17-2025-52-CC-MPRE-DCZVR6-20250117153926

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700591
Report Date: 01/17/2025
Date Signed: 01/17/2025 03:39:37 PM

Document Has Been Signed on 01/17/2025 03:39 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SAFARI KID - HAYWARD		FACILITY NUMBER:	015700591
ADMINISTRATOR/ DIRECTOR:	RATHI, SEEMA		FACILITY TYPE:	850
ADDRESS:	26236 ADRIAN AVENUE		TELEPHONE:	(510) 364-9651
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94545
CAPACITY: 101	TOTAL ENROLLED CHILDREN: 78	CENSUS: 57	DATE:	01/17/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Seema Rathi		TIME VISIT/ INSPECTION COMPLETED:	03:36 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 1/17/2025 at 9:20am Licensing Program Analyst (LPA) Morgan Pringle met with Director Seema Rathi for an Unannounced Annual/Random Inspection. There were fifty-seven (57) preschool age children, and eleven (11) additional staff present during the inspection. Six (6) classrooms, Purple Room (toddlers), Green Room (toddlers), Blue Room, Orange Room, Yellow Room and Peach Room were toured for a health and safety inspection. The facility is on the New Bridges Presbyterian Church grounds and the preschool operates in Buildings 1 and Building 7. The facility operates from 7:30am – 6:00pm, Monday – Friday. LPA observed all classrooms to have ample age-appropriate materials for the children’s learning and play that were clean, properly stored and in proper working order. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. LPA verified there were no medications on site. The facility has designated areas to store medications when needed. LPA observed all bathrooms to be clean, well maintained, with ample number of sinks and toilets. The changing tables in the purple and green rooms were observed to be properly padded, clean, and well maintained. All diapering materials were properly stored as well. All napping materials were observed to be well maintained and properly stored. The facility provides sleeping cots, and all bedding is brought from the children’s home. There are multiple properly working smoke detectors, carbon monoxide detectors, fire extinguishers, and first aid kits on site. There are two (2) wall heaters in each classroom that have been barricaded and made inaccessible to the children in care. The facility does not transport children. LPA observed the thermostat in the yellow room showing the temperature was 52 degrees F. LPA informed Director that the temperature inside a classroom much stay between a minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C). One heater in the room began working and Director stated the other heater will be fixed when the children leave for the day. Page 1 of 4

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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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Document Has Been Signed on 01/17/2025 03:39 PM - It Cannot Be Edited

Created By: Morgan Pringle On 01/17/2025 at 02:07 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 - HAYWARD	FACILITY NUMBER: 015700591
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229.1(a)(1)

Sign In and Sign Out

(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Four (4) children present were signed in by a staff member when the child's parent/authorized representative forgot. Based on record review the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/22/2025
	Plan of Correction
1 2 3 4	Director will inform staff that they may not sign children in or out of the facility as they are not an authorized representative. Director will submit to LPA Pringle a completed sign in/out log for the 4 children and a written statement from each staff member stating they understand they are not to sign children in or out of the facility by Wednesday, 1/22/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Jason Jang

LICENSING EVALUATOR NAME:

Morgan Pringle

LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC809 (FAS) - (06/04)

Page: 2 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - HAYWARD	FACILITY NUMBER: 015700591
	VISIT DATE: 01/17/2025

NARRATIVE

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Families have the option to bring their own lunch or sign up for a school lunch. All snacks are brought from the children’s home. All food prep areas were observed to be clean and well maintained. All children bring their own water bottles and have access to clean drinking water.

The outside play yard was observed to be fully fenced, well maintained, with ample age-appropriate materials for the children. All play materials for the children were observed to be clean and in good repair. There is plenty of shade for the children. There are two (2) large storage sheds that are locked and inaccessible.LPA did not observe any bodies of water in or around the facility.

The facility is operating within its licensed capacity is in ratio. All staff working at the facility have obtained a criminal record clearance or have transferred their clearances. The fire/disaster drill log is complete with the last drill logged 1/13/2025. A physical census of the children was taken and cross referenced with the sign-in and out log. LPA found that four (4) children were not signed in by their authorized representative (see LIC809D). LPA obtained a sample of the children’s files, staff files, and the facility files. All files were complete.

Deficiencies cited during LPA’s inspection
· Four (4) children not properly signed in

Director was reminded that California law requires facilities to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, facilities must submit the Unusual Incident/Injury form (LIC 624) to the Department. Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Personnel and facility rosters must be properly maintained, and fire/disaster drills must be conducted at least every six (6) months and documented. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - HAYWARD	FACILITY NUMBER: 015700591
	VISIT DATE: 01/17/2025

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed 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.

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 PIN 22-02-CCP. 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/.

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.

Director 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.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID - HAYWARD	FACILITY NUMBER: 015700591
	VISIT DATE: 01/17/2025

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Seema Rathi.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC809 (FAS) - (06/04)

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