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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494141
Report Date: 07/01/2019
Date Signed: 07/01/2019 10:25:32 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CHILDREN'S CREATIVE WORKSHOPFACILITY NUMBER:
197494141
ADMINISTRATOR:SHARI LATTAFACILITY TYPE:
850
ADDRESS:30237 MORNINGVIEW DRTELEPHONE:
(310) 266-2010
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY:40CENSUS: 0DATE:
07/01/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Shari Latta, ApplicantTIME COMPLETED:
10:30 AM
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On 07/02/2019 at 08:30 am, Licensing Program Analyst (LPA) Sabrina Martinez conducted an announced site visit at Children's Creative Workshop located at 30237 Morningview Drive, Malibu CA 90265 and met with Shari Latta, applicant, for the purpose of a change of location pre licensing inspection.

The applicant is the licensee of a facility currently licensed by the Department (license # 191690113). The applicant is requesting for a license with a capacity of 40 serving ages 2-5 year olds and has a granted fire clearance for a capacity of 40.

LPA toured the facility inside and outside. The facility is located on the site of Juan Cabrillo Elementary School (SMUSD). The facility will occupy 2 classrooms (Rooms 1 and 2) on the south west end of the campus. Applicant will have exclusive use of the classrooms during hours of operation.

Hours of Operation/Quiet Time/Equipment
The program will be open from Monday through Friday 8:00 am to 4:00pm Children will be offered quiet time daily. There are sufficient mats for children. Applicant is reminded that children utilizing the mats must have some type of barrier between them and the mat, sheets or blankets may be used. Sheet and blankets must be stored separately when not in use.

Sign in and sign out

Applicant and the Director is to ensure that the person who signs the child in/out shall use his/her full legal signature and shall record the time of day The main sign in will be inside the classroom.

SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CHILDREN'S CREATIVE WORKSHOP
FACILITY NUMBER: 197494141
VISIT DATE: 07/01/2019
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Indoor Activity Space
Based on the measurements obtained, the indoor space allows the requested capacity of 40 children. LPA observed furniture and equipment to be in good condition, free of sharp, loose, or pointed parts. LPA observed one sink in each classroom. The children's restroom is located in between the two classrooms. There are (2) toilets and (1) sink in this restroom. Applicant also has exclusive use of the boy's restroom located in the second building adjacent to the classrooms. LPA observed (1) toilet, (2) sinks and (3) urinals. The facility has a total of (3) toilets and (5) sinks which is sufficient for the 40 children as requested. There is dispensable soap and paper towels in the bathrooms. The staff bathroom is located next to the boy's restroom. Isolation area if needed is located on a mat in the office area.

Overhead lighting provides the majority of the light in the classroom, but sunlight comes through doors and windows. Cubbies are available for children's belongings. LPA observed drinking water available for the children as well.

Outdoor Activity Space
Based on the measurements obtained, the outdoor space allows the requested capacity of 40 children. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. The playground is enclosed by a fence which is at least four feet high. Per the applicant, the children in care will be bringing their own water bottles and water bottles will be available for children when outside in the yard.

Medication/First Aid Kits
Medication if administered is to be properly labeled and stored in the original container. Applicant and Director were advised that children should be screened every morning for illness and unusual marks. First Aid supplies are stored in the classroom and in the general adult areas.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CHILDREN'S CREATIVE WORKSHOP
FACILITY NUMBER: 197494141
VISIT DATE: 07/01/2019
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For each aide under age 18, verification of high school graduation or current participation in an occupational program conducted by an accredited high school or college.
Criminal Record Statement (LIC 508) for staff subject to fingerprint requirements.
Fingerprint clearances - Proof of clearance (Criminal Record, FBI and Child Abuse).
Appropriate driver's license for person(s) transporting children.

Licensee shall maintain Administrative Records which shall have the following:


Administrative Records
Written inspection procedures for accepting children on a daily basis.
Sign-in/sign-out sheets kept for current 30 days, or approved waiver to use electronic pin system.
Admission policies, including admission criteria, ages of children who will be accepted; medical assessment requirements; program activities, supplemental services, if any; field trip provisions, transportation arrangements, food service, if any.
Designation of Facility Responsibility (LIC 308).
Personnel Report (LIC 500) showing current roster.
Licensee affidavit regarding persons exempt from fingerprint requirements (Use back of LIC 500).
Emergency Disaster Plan (LIC 610) (a posting requirement; see below) with verification that disaster drills are conducted every six months. Documentation of drills shall be maintained for at least one year.Up-to-date list of qualified teacher substitutes.
Documentation of exceptions and waivers: Facility Waiver Request (LIC 956) and Exception/Exemption Request (LIC 971).
Annual licensing reports and substantiated complaints from the last three years (must be available at the center for public review). and a Child Care Facility Roster (LIC 9040).

The applicant was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541.Email Address: childcareadvocatesprogram@dss.ca.gov.

Based on todays inspection the facility shall be recommended for licensure pending management approval.

An exit interview was conducted and a copy of this report was provided to Shari Latta, applicant.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 4 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CHILDREN'S CREATIVE WORKSHOP
FACILITY NUMBER: 197494141
VISIT DATE: 07/01/2019
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The following was discussed with the applicant:

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.html.

Required Postings/Licensee shall have posted in the Child Care Center at all times the following:



Facility license.
Personal Rights form (LIC 613A).
Menus.
Child passenger restraint system poster. (PUB 269).
Daily activity schedule.
Emergency Disaster Plan (LIC 610) and Earthquake Preparedness Checklist (LIC 9148).
Parent’s Rights Poster (PUB 393).
Notice of Site Visit (LIC 9213).
Any licensing report documenting a type”A” citation must be posted for 30 days.
Any licensing report or other document verifying compliance or non-compliance with the Department’s order to correct a Type A deficiency must be posted for 30 days.

Employee/Volunteer Files shall also be maintained and shall contain the following


Health Screening Report - Facility Personnel (LIC 503) and TB Clearance.
Proof of Immunizations
Mandated Reporter Training Certificate of Completion
TB Clearance and "Good Health" statement from volunteers.
Personnel Record (LIC 501) or application/resume.
Evaluation of Director Qualifications (LIC 9096).
Evaluation of Teacher Qualifications (LIC 9095).
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4