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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412165
Report Date: 09/23/2022
Date Signed: 09/23/2022 01:16:11 PM

Document Has Been Signed on 09/23/2022 01:16 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, INC.FACILITY NUMBER:
434412165
ADMINISTRATOR:NAMRATA WALANIFACILITY TYPE:
850
ADDRESS:1402 DEMPSEY ROADTELEPHONE:
(408) 945-9032
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 32DATE:
09/23/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Namrata WalaniTIME COMPLETED:
01:45 PM
NARRATIVE
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On Friday, September 23, 2022 at 10 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Case Management Annual Continuation Visit. LPA met with the Director Namrata Walani and explained the nature of site visit. Present on this visit were 7 staff, 12 toddlers and 20 preschool children. Facility operates from Monday to Friday 8:30 am to 6pm.

LPA toured the facility to conduct a Health and Safety Inspection with the Director. Facility has a Toddler Component. Facility was observed to be following teacher to children ratio requirement during the inspection. Children were engaged in various activities under the visual supervision of the teachers.

At 10:15 am, LPA Estoesta observed 32 children in care and only 28 children in care were Signed In by their Authorized Representative through the Facility "Pro Care" software application. See LIC 809 D.

At 10:30 am, during the LPA's Staff Record Review, Staff 1 initiated Background Check Process and was not associated to the facility. SEE LIC 809 D.

LPA informed the Director that this report dated 09/23/2022 with two (2) Type B citation which shall be posted as there are potential risks to the health, safety, or personal rights of children in care.

LPA obtained copies of the Facility's LIC 500 and Children's Roster.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Namrata Walani.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 09/23/2022 01:16 PM - It Cannot Be Edited


Created By: Manel Estoesta On 09/23/2022 at 11:37 AM
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, INC.
FACILITY NUMBER: 434412165

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2022
Section Cited
CCR
101170(e)(3)

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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 101170(f) or...
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The Director will utilize the Guardian Portal and the Director will submit the completed and signed LIC 9163 to the Regional Office on or before 09/26/2022.
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At 10:30 am, during the LPA's Staff Record Review, Staff 1 initiated Background Check Process and was not associated to the facility which is a potential risks to the health, safety, or personal rights of children in care
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LPA advised the Director to conduct a Staff meeting, utilize watching the California Child Care Licensing Child Care Center Operators Videos and documenting the meeting. The Director understood.
Type B
09/26/2022
Section Cited
CCR101229.1(a)(1)

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(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.
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The Director will request in writing from the children's Authorized Representative who failed to signed in on today's date, to complete the today's date Children's Sign In and Out, reminder of the importance of the Child Sign In and Out and this requirement documentation will be submitted to Regional Office on or before 09/30/2022.
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At 10:15 am, LPA Estoesta observed 32 children in care and only 28 children in care were Signed In by their Authorized Representative through the Facility "Pro Care" software application which is a potential risks to the health, safety, or personal rights of children in care
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LPA advised the Director to conduct a Staff and Parent meeting, utilize watching the California Child Care Licensing Child Care Center Operators Videos and documenting the meeting. The Director understood and Director will create a new plan on Children's Sign in and Out.
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:Manel Estoesta
LICENSING EVALUATOR SIGNATURE:
DATE: 09/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2022


LIC809 (FAS) - (06/04)
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