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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100405182
Report Date: 12/04/2023
Date Signed: 12/04/2023 03:04:01 PM


Document Has Been Signed on 12/04/2023 03:04 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
FRESNO-CC, 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: 32DATE:
12/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Adam Dermer-AministratorTIME COMPLETED:
03:15 PM
NARRATIVE
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On 12/04/2023, Licensing Program Analyst (LPA) Ka Vang conducted a Case Management Inspection to follow-up the Plan of Correction (POC). The purpose of the inspection was to review the POC for the deficiency cited on 07/13/2023. During today’s inspection, LPA met with Administrator Adam Dermer. LPA toured the facility, and a census was taken.

LPA reviewed the deficiency that was cited on 07/13/2023 with Adam Dermer. LPA was not able to clear the deficiency during the case management inspection as facility did not have proof that the facility had retested their drinking and cooking water.

During the inspection, LPA observed that Staff #1 was the site supervisor; however, the facility did not submit proof to Community Care Licensing (CCL)-Fresno Office that Staff #1 met the site supervisor qualified.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, there are deficiencies been cited during today’s inspection. (See page LIC809-D for additional information).



The facility representative was provided a copy of appeal rights. A notice of site visit (LIC 9213) was given and must remain posted for 30 days. This report shall be made available to the public upon request. Exit interview conducted and report was reviewed with Adam Dermer.
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
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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Document Has Been Signed on 12/04/2023 03:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: DERMER'S CREATIVE CARE
FACILITY NUMBER: 100405182

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/18/2023
Section Cited
HSC
1597.16(a)(1)

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(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
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Facility representative agrees to submit proof that the drinking and cooking water, for the D-Drinking Fountain_RM 1, E-Drinking Fountain_RM 2, F-Drinking Fountain _RM 4 and C-Drinking Fountain_Back Porch, have been retested and is at below or at the 5.5 ppb level.
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Based on record review, the licensee did not comply with the section cited above. On 07/31/2023, facility representative provided proof that the facility has their drinking and cooking water tested and have lead exceedance on multiple faucets. Facility representative stated that he is scheduling an appointment for the water to retest for lead level as the faucets have been replaced. During today’s inspection, Licensee failed to provide retest results for the building as the building was constructed before January 1, 2010. This poses a potential health, safety, or personal rights risk to children in care.
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Facility representative agrees to submit proof to Community Care Licensing (CCL)-Fresno by 12/18/2023.
Type B
12/18/2023
Section Cited
CCR101215.1(b

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(b) All child care centers shall have a director. This requirement is not met as evidenced by:

Licensee failed to submit proof that Staff #1 meets the requirement as a Site Supervisor. Facility representative stated that Staff #1 just started her employment with this facility as
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Facility representative agrees to submit proof to CCL-Fresno Office by 12/18/2023 that Staff #1 meets the requirements as a Site Supervisor.
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Site Supervisor on 12/04/2023. This poses a potential health, safety, or personal rights 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: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
LIC809 (FAS) - (06/04)
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