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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408278
Report Date: 07/31/2023
Date Signed: 07/31/2023 10:06:52 AM


Document Has Been Signed on 07/31/2023 10:06 AM - 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:SAFARI KID-WALNUT CREEKFACILITY NUMBER:
073408278
ADMINISTRATOR:AUTUMN CAZENASFACILITY TYPE:
850
ADDRESS:2210 OAK GROVE RDTELEPHONE:
(925) 464-7663
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:75CENSUS: 37DATE:
07/31/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Autumn CazenasTIME COMPLETED:
10:30 AM
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On 7/31/23 at 8:40 am Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Plan of Correction Inspection at Safari Kid Walnut Creek and met with opening teacher Ms. Neha greeting parents and children at the entrance for morning drop off. Director, Autumn Cazenas arrived at 8:50 am.

During required inspection on 7/20/23 facility was issued citation for Measles (MMR) record for all staff and technical violation for Sleep Log for toddlers ages 18-24 months. Purpose of today's inspection is to verify documents. Director provided MMR verifications for all staff and copy of sleep log. Citation issued on 7/20/23 is cleared today. Letter of Clearance was provided today.

During today's inspection, LPA observed between 8:40 - 8:50 am while staff S1 was handling drop off parents and children at entrance and walking them to their classrooms, there was a child (C1) sitting at a table in the receiving lobby area. S1 was close by and able to see the child occasionally, but because she was focusing on receiving children and parents, was unable to provide 100% visual supervision to C1. When Director arrived LPA discussed this situation. Director stated C1 has difficulty at drop offs and insists not go into her classroom for about 15 minutes and to stay with S1. LPA discussed requirements for visual supervision and possible solutions for C1's supervision in the morning. Director stated she will come up with a plan for handling C1 to ensure 100% visual supervision is being provided and child's needs are being met while in care.

No deficiencies were issued today. Technical Violation was provided for Care and Supervision. This report was reviewed with Director, Autumn Cazenas. NOTICE OF SITE VISIT WAS ISSUED, MUST BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2023
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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