434412165-7-15-2021-52-CC-MESA-C4XT37-20210715142154

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412165
Report Date: 07/15/2021
Date Signed: 07/15/2021 02:22:01 PM

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, INC.		FACILITY NUMBER:	434412165
ADMINISTRATOR:	RUMA CHOKSHI		FACILITY TYPE:	850
ADDRESS:	1402 DEMPSEY ROAD		TELEPHONE:	(408) 945-9032
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	96	CENSUS: 36	DATE:	07/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Ruma Choksi		TIME COMPLETED:	02:30 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 Thursday, July 15, 2021 12:01 PM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year visit. LPA met with the Director Ruma Choksi and explained the nature of site visit. Present on this visit were 6 staff and 36 preschool children. Facility operates from Monday to Friday 9am to 6pm. LPA toured the facility to conduct a Health and Safety Inspection with the Director. Facility was observed to be in compliance with teacher to children ratio requirement during the inspection. Children were engaged in various activities under the visual supervision of the teachers. The classrooms, restrooms, staff kitchen, storage room, and office area were inspected. Director stated that facility does not possess nor store any weapons on the premises. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Furniture and equipment such as mats, cots, tables, and chairs were age appropriate and were in good condition, free of sharp, loose, or pointed parts. Restrooms for children's use were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Outdoor Activity space is fenced and play equipment were maintained in a safe condition and free of hazards. There were no bodies of water observed. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were shaded rest areas for children. Drinking water are arranged to be readily available to children during indoor and outdoor activities. Facility contracts with a third party vendor who provides Lunch for children. Children brings their own snacks from home. Menu is observed to be posted. Trash cans for solid waste had tight-fitting covers on, and were in good repair. SEE 809 C.....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SAFARI KID, INC.	FACILITY NUMBER: 434412165
	VISIT DATE: 07/15/2021

NARRATIVE

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Continuation......

Facility currently has an Incidental Medical Services Plan for the provision of Epinephrine. Director stated that facility currently does have children in care who requires Incidental Medical Services. 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.

Facility does not provide transportation for children but Director understands that children cannot be left alone, unattended in park vehicles. Fire extinguisher was last serviced January 2020 and has a scheduled on 07/27/2021. LPA observed Smoke and Carbon Monoxide Detectors, sprinkle system, and fire alarm pull stations. Log shows that the last Fire Drill was conducted on 03/26/2021.

Facility files were reviewed. Children sign in and out procedures and logs were reviewed. Facility is currently using an electronic sign in and out system called "runsandbox." LPA reviewed the system's operation/logging with Director. A sampling of Children's files was taken for review. The records reviewed include Admission Agreement, Identification and Emergency Information, Medical Assessment, Immunization, and Consent for Emergency Medical Treatment.

A sampling of Staff's files was taken for review. The records reviewed include: Criminal Record and Child Abuse Index Clearance, Health Screening Report with TB Clearance, Education Qualification, records of immunization against Measles and Pertussis, and Training such as the AB1207 Mandated Reporter Certification. There was at least 4 staff with current certification in Pediatric CPR and First Aid present at the facility during inspection.

Director has a Lead Poisoning Prevention Training in April 2021 and LPA gave and discussed the PIN 20-01.

SEE 809C......

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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, INC.	FACILITY NUMBER: 434412165
	VISIT DATE: 07/15/2021

NARRATIVE

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Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. The training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at:
https://www.mandatedreporterca.com/

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 with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $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 to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

In the areas that were evaluated, there were NO regulatory violations. NO citation were issued.

Exit Interview was conducted,

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: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

LIC809 (FAS) - (06/04)

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