214005535-5-28-2021-05-CC-HRCO-C3FVQ4-20210528163742

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005535
Report Date: 05/25/2021
Date Signed: 05/28/2021 04:37:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CREATIVE GARDENS		FACILITY NUMBER:	214005535
ADMINISTRATOR:	LI, WEI CHRISTOPHER		FACILITY TYPE:	830
ADDRESS:	120 DONAHUE STREET		TELEPHONE:	(415) 577-8389
CITY:	SAUSALITO	STATE: CA	ZIP CODE:	94965
CAPACITY:	28	CENSUS: 0	DATE:	05/25/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Wei Christopher Li		TIME COMPLETED:	02:30 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) Haydee Caliboso met with applicant Wei Christopher Li, today for a pre-licensing inspection. The applicant has requested a combination of an infant program with preschool and toddler component program. The infant program will be part of a combination center as the applicant has also applied for a preschool license for 51 children (ages 3 to Kindergarten) and 24 toddler (ages 18 months – 36 months) at the same location. The applicant has requested 28 infant, ages birth to 18 months. The facility plans to operate Monday - Friday; 7:30 AM to 6:30 PM. The designated Site Supervisor for the facility will be Wei Christopher Li. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. This inspection included a technical assistance inspection for COVID-19 guidance and support. Indoor: There are two designated classrooms that will be used for the infant program. Infant classroom (#3): was calculated for a total of 551.72 sq. ft allowing for a capacity of 14 infants. Infant classroom (#4) was calculated for 672 sq. ft allowing for a capacity of 14 infants. The classrooms are observed today to be clean and equipped with fire extinguisher, smoke and carbon monoxide detectors. The facility is adequately ventilated and free of insects and bugs. The classroom and furniture equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. There is storage space for children's personal belongings. The facility has first aid kit in each classroom and designated backpack with emergency supplies. Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. The facility has a designated kitchen area where is food is prepared, a working refrigerator, and a working dishwasher where utensils are to be cleaned. Cont. 809-C pg. 2

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CREATIVE GARDENS	FACILITY NUMBER: 214005535
	VISIT DATE: 05/25/2021

NARRATIVE

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The parents in the program will provide lunch daily. The program will provide morning and afternoon snacks daily. The program will provide a sheet and blanket for the infant children. Bedding is to be washed twice a week or as needed. Cots will be used for older infants and will be cleaned daily or as needed.

Infant: There is storage for infants’ personal belongings. The parents will provide diapers and wipes for the infant. The infant program has a designated kitchen with built-in counter-top area, a working refrigerator, sink available for staff to use, bottle warmers, and garbage cans with tight-fitting lids. The bottle warmer is out of reach of children.
There are 3 cribs available for infant to use in each infant classroom. The Director stated, additional cribs will be purchased as enrollment increases. The infant program has 3 diaper changing table area available for children to use within arm’s reach of a sink. Medications for infants will be stored in the classroom and in high cabinets or in locked boxes in the refrigerator. All furnishings and equipment are observed to be safe, in good condition, and age appropriate. Staff will meet and review needs and service individual written plans quarterly with the parents. Plan will be kept in children's file.

There is a separate bathroom available for staff to use. Isolation area for ill children is located at the site supervisor office. Staff bathrooms will be used for ill children, if needed, until parents arrive for pick-up. Children in the program will be signed in and out daily by parents using an electronic signature. The facility will conduct and log fire drills once every six months, and the log will be available upon request. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children.

Outdoor: There are 2 infant outdoor area that will be used in the facility and the following square footage was calculated for each one. Outdoor area (#1) was calculated for a total of 330 sq. ft, allowing for a total of 4 infant children, outdoor area (#2) was calculated for a total of 75.4 allowing for a capacity of 1 child only. The facility will provide a letter request for a waiver for scheduled outdoor rotation usage. The facility’s outdoor playground is enclosed and gated approximately 10 ft. tall. The outdoor space was observed to be clean, safe, and equipped toys that are age-appropriate for children. The outdoor space playground has green turf for cushion. LPA advised that each program is to be separated at all times and are not allowed to use the outdoor area simultaneously.
Cont. 809-C pg. 3

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CREATIVE GARDENS	FACILITY NUMBER: 214005535
	VISIT DATE: 05/25/2021

NARRATIVE

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The following items were reviewed as part of today’s visit: Record keeping for staff, children, and facility records, care and supervision of the children, child discipline procedures – staff will use positive discipline. Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Safe Sleep and Individual Infant Sleeping Plan (LIC 9227), Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements were reviewed today.

This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

An electronic copy of this three-page report was emailed to Wei Christopher Li and. Applicant was asked to review the report and return a signed copy of the report to LPA Haydee Caliboso. COVID-19 Self-assessment guide was received and reviewed today with the Director.

The following corrections need to be submitted and further reviewed:
· Ample age appropriate outdoor toys for infant program.
· LIC 404

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of this facility for a total capacity of 28. The following is required prior to licensure:

· Letter request for a waiver for scheduled outdoor rotation usage for infant program.
· Revised LIC 200A

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

LIC809 (FAS) - (06/04)

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