434413043-3-11-2025-07-CC-MKAR-DEHVFD-20250306152342

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413043
Report Date: 03/06/2025
Date Signed: 03/11/2025 09:10:11 AM

Document Has Been Signed on 03/11/2025 09:10 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SAFARI KID - SUNNYVALE		FACILITY NUMBER:	434413043
ADMINISTRATOR/ DIRECTOR:	RAMAKRISHNAN, SUHASINI		FACILITY TYPE:	850
ADDRESS:	1271 WEST EL CAMINO REAL		TELEPHONE:	(650) 962-1366
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY: 100	TOTAL ENROLLED CHILDREN: 62	CENSUS: 40	DATE:	03/06/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Srikala Thota		TIME VISIT/ INSPECTION COMPLETED:	03:25 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	Licensing Program Analyst(LPA) Mandeep Kaur met with Assistant Director,Srikala Thota, for an unannounced Annual/Random inspection. The purpose of today's inspection was explained with Assistant Director. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The preschool program has two active waivers: outdoor space and Heritage program to pass through Preschool classroom. The center's operating hours are Monday through Friday from 08:30 AM to 6:00 PM. The facility is licensed to serve children ages 2 years to entry into first grade in Rooms 1 through 5. LPA toured the indoor and outdoor areas. LPA observed that the teacher-child ratio was in compliance. Fire drill was conducted on October 20, 2024. The facility has current children's roster and a copy was provided to LPA during the inspection. Cleaning products, disinfectants, sharp objects were stored inaccessible to children. Furniture and equipment were observed to be age appropriate and in good condition. The facility is clean. The bathrooms for children and staff are clean, sanitary, and operable. LPA observed 7 toilets and 7 sinks available for the children. Assistant Director stated that the center has a third party cleaning service that comes and clean the facility after daycare hours. The center provides lunch to the children that is delivered from the third party vendor School caters. Drinking water is available for the children indoor via filtered water bottles and sippy cups. LPA observed trash cans with tight fitting covers for the disposable of solid waste. The facility has fire extinguishers and working smoke and carbon monoxide detectors. *Continuation on next pages*

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAFARI KID - SUNNYVALE	FACILITY NUMBER: 434413043
	VISIT DATE: 03/06/2025

NARRATIVE

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The playground is surrounded with appropriate fencing and the outdoor surfaces are safe. Shade is provided. Drinking water is readily available for the children outdoor via filtered water bottles and sippy cups. LPA observed climbing structures with resilient material under and around the structures. There were no bodies of water observed. Assistant Director stated that there are no weapons or firearms on the premises.

LPA reviewed 6 random children's files. Children records reviewed include Admission Agreement,
Identification and Emergency Information, Consent for Emergency Medical Treatment, Physician's Report, TB test, Immunizations, Parent Right's Receipt, Personal Rights, and Health History. Based on records review and interview with Assistant Director, 3 (C1, C2 and C4) out 6 children are missing LIC 9224(Acknowledgement of receipt of licensing report) for the Type A citation that was issued on 04/05/2024. Assembly bill 633 was discussed with Assistant Director. LPA informed Assistant Director to provide a copy of the licensing report dated 04/05/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of the report, 04/05/2024. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), or other written statement, must be placed in the child's file for verification.

LPA reviewed 7 staff files. Staff records reviewed include Employee Rights, Statement Acknowledging
Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunizations (Measles,
Pertussis, and Influenza) and required training.LPA reminded Assistant Director that the Mandated Reporter Training shall be renewed by all staff every two years and immunizations records for the staff needs to available for review in file. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

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/.

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SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAFARI KID - SUNNYVALE	FACILITY NUMBER: 434413043
	VISIT DATE: 03/06/2025

NARRATIVE

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Assistant 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.

Assistant 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&R's) throughout California.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

As a result of this inspection, one Type B deficiency was issued on the attached page: 809D. Appeal rights provided.

Exit interview conducted and report was reviewed with Assistant Director, Srikala Thota.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/11/2025 09:10 AM - It Cannot Be Edited

Created By: Mandeep Kaur On 03/06/2025 at 12:21 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAFARI KID - SUNNYVALE	FACILITY NUMBER: 434413043
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8595(c)(2)

Posting licensing report by child care facility or homeduration of posting; civil penalty for failure to comply; reports to be provided to parents or guardian of each child receiving services: (2) Upon enrollment of a new child in a facility, the licensee shall provide to the parents or legal guardians of the newly enrolling child copies of any licensing report that the licensee has received during the prior 12-month period that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interviews and records review, the licensee did not comply with the section cited above where LIC 9224( Acknowledgement of Receipt of licensing reports) is not signed by the parents of 3 children( C1, C2, and C4) out of 6 children for not sharing the Type A citation report that was issued on 04/05/2024, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/20/2025
	Plan of Correction
1 2 3 4	By plan of correction due dfate, 03/20/2025, Licensee will submit the copy of LIC 9224 (Acknowledgement of Receipt of licensing reports) signed by parents of children (C1, C2 and C4) of sharing the licensing reports that was issued on 04/05/2024 with Type A citation to the department.

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:

Belinda Devall

LICENSING EVALUATOR NAME:

Mandeep Kaur

LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

LIC809 (FAS) - (06/04)

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