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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100405182
Report Date: 05/02/2019
Date Signed: 05/02/2019 02:12:48 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:DERMER'S CREATIVE CAREFACILITY NUMBER:
100405182
ADMINISTRATOR:DERMER, ADAMFACILITY TYPE:
850
ADDRESS:321 W. HERNDON AVENUETELEPHONE:
(559) 435-2901
CITY:PINEDALESTATE: CAZIP CODE:
93650
CAPACITY:77CENSUS: 27DATE:
05/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Adam DermerTIME COMPLETED:
11:30 PM
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Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random inspection and met with Assistant Director, Gene Herrera. LPA explained the reason of the inspection and tour of the center was conducted both inside and outside. The center operates year round from Monday thru Friday from 07:00 AM to 06:00 PM.

There are a total of two classrooms. LPA Observed 11 children under the supervision of 1 teacher and 1 aide. The second classroom had 16 children under the supervision of 2 teachers. Both classrooms were observed to be clean. LPA observed Clorox, Lysol, and other cleaning products stored underneath the sink. The latch was not working properly. LPA advised Gene and the teachers. The latch was fixed shortly after gene was made aware. LPA observed plenty of age appropriate toys inside each classroom, books, coloring materials, and small tables and chairs. Furniture, toys and equipment were observed to be clean and in good repair. There is water available both inside and outside. Menus are posted inside each classroom. Gene stated there are no guns/weapons at the center. LPAs did not observe any bodies of water on the property. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. LPA reminded gene to not throw away any solid waste in trash cans that don't have a tight fitting cover. Director, Adam Dermer joined the tour shortly after.

The center does plan to provide IMS. The Center will submit an IMS plan and states that the medication will be stored inside the office in a locked box. At least one teacher is current with their CPR/FIRST AID, which is good until 05/20/2019. Parent Sign in / sign out sheet was reviewed. LPA reminded licensee to review the sign in and sign out sheet everyday and make sure parents are signing their children in every day. A sampling of children's files was re reviewed and everything was complete and up to date. A sampling of staff files were reviewed and it was confirmed that Teacher #1 and Teacher #2 did not have transcripts on file while Teacher #2 and #3 do not have proof of immunization requirements.
Report Continued on LIC 809- C
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: DERMER'S CREATIVE CARE
FACILITY NUMBER: 100405182
VISIT DATE: 05/02/2019
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During the tour it was observed that their was an individual who was working with the children who did not have a fingerprint clearance. Adam stated that Madison Berry is contracted by the children parents and comes every Thursday to work with specific children. Madyson goes into the teachers break room and works with children alone. LPA notified Adam that Madyson or any person that has any direct contact with the children need to have a fingerprint clearance and have immunization records on file. A civil penalty of $100 was assessed today during the inspection for having Madyson Berry work with children unsupervised.

LPA provided Adam a brochure regarding new lead guidelines. The bathroom was found clean and free of hazards or toxins during the inspection. There is a functioning carbon monoxide detector that meets statutory requirements. The outdoor play area was observed to be completely fenced, with age appropriate play structure and shade area. The required State forms were posted on the parent board.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

During todays inspection, The following type A and Type B deficiencies were observed. Appeal rights were explained and provided to Director.

Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.



LPA observed licensee post the Notice of Site visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: DERMER'S CREATIVE CARE
FACILITY NUMBER: 100405182
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/03/2019
Section Cited
HSC
101170(e)(1)
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(e) 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: (1) Obtain a California clearance or a criminal record exemption as required by the Department
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Licensee stated that Madyson will not attend the day-care until she has a fingerprint clearance. Director will write a plan of correction stating how this will not happen again and submit a written copy to CCL by no later than 05/03/2019.
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This requirement was not met as evidence by LPA observing and Director stating that Madyson Berry comes to the center every Thursday to work with specific children. This poses an immediate health/safety risk to the children in care.
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: DERMER'S CREATIVE CARE
FACILITY NUMBER: 100405182
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2019
Section Cited
CCR
101616.2(d)
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Teacher Qualifications and Duties. Original certified copies of transcripts verifying the completion of the required units shall be filed in each teacher's personnel file. This requirement was not met as evidence by LPA conducting file reviews and Gene stating
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Gene stated that she will get copies of their Transcripts and submit proof to CCL by no later than 05/24/2019.
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that Teacher #1 and Teacher #2 did not have transcripts on file. This poses a potential health/safety risk to children in care.
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Type B
05/24/2019
Section Cited
HSC
1596.7995(a)(1)
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Employees or volunteers at day care center; immunization requirements; records; exemptions. Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and
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Director agrees to submit proof of immunization's for Teacher #2 and #3 by no later than 05/24/2019 to CCL.
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volunteer shall receive an influenza vaccination... This requirement was not met as evidenced by File review and speaking with director that Teacher #2 and #3 do not have proof of immunization requirements. This poses an potential health/risk to children in care
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4