214005535-4-28-2022-05-CC-HRCO-CDX3H2-20220428181509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005535
Report Date: 04/28/2022
Date Signed: 04/28/2022 06:16:28 PM

Document Has Been Signed on 04/28/2022 06:16 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
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		TELEPHONE:	(415) 577-8389
CITY:	SAUSALITO	STATE: CA	ZIP CODE:	94965
CAPACITY:	28	CENSUS: 20	DATE:	04/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Wei Christopher Li		TIME COMPLETED:	01:40 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 the Wei Christoper Li (Director), to conduct an unannounced annual inspection on 4/28/22. LPA arrived at the facility at 11:45PM. The purpose of the inspection was explained. Present during the inspection were 20 infant children and 6 staff including the Director. LPA observed that the program is operating within ratio on this day. At 12:30pm, Agnes Lau (Director) arrived at the facility. The facility operates Monday – Friday, 7:30 AM to 6:30PM. The facility was inspected today, classrooms #3 & #4, indoors and outdoors for health and safety hazards. LPA observed no bodies of water at the facility. Director stated there are no firearms or weapons in the facility. The facility is equipped with smoke detector, carbon monoxide detectors, fully charged fire extinguishers and a working telephone available. The classrooms have adequate ventilation and lighting. LPA observed all cleaning solutions, poisons and other chemicals that are dangerous to the children are stored made inaccessible to the children. The classrooms are equipped with age-appropriate toys and furniture. The furniture is steady and in good repair. Facility floor is clean, in good repair and free of any hazards. LPA observed hand washing equipment are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight fitted lid on top. The program has drinking water available for children for indoors and outdoors. Outdoor play structures are age appropriate and in good working condition, free of loose parts, free of hazard, and with sufficient cushion underneath. First aid kit and emergency supplies are properly maintained and kept inaccessible to children. Director stated that there are currently no children in the program who needs medications in placed while in care. Cont. 809-C pg. 2

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

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: 04/28/2022

NARRATIVE

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LPA reviewed children’s files during today’s inspection. LPA observed all files are complete and up-do-date. LPA observed facility has record of names, addresses and telephone numbers of each child 's authorized representative. LPA observed Needs and Service Plan and Individual Safe Sleep Plan are in file. Each child's record contains the record immunization. Multiple staff members have record of valid CPR card in file. LPA reviewed the educational qualification of all the teachers. Facility has a log for emergency drills being conducted. Per log, last emergency drill was conducted on 03/2022. Per Director the program is not providing transportation.

The Director was reminded about Mandated Reporter training available on the CCLD website. In addition to the AB1207 training that must be completed every two years by all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. LPA observed multiple staff have completed the child abuse training. Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA informed the to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates. Licensee was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800. For rules and regulations, visit the website: www.cdss.ca.gov

Licensee was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Cont. 809-C pg. 3

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

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: 04/28/2022

NARRATIVE

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LPA discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA discussed Incidental medical Services-IMS. LPA reviewed storage of medication and equipment/supplies.

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

The report was reviewed and signed by the Director, Wei Christopher Li. Today’s report and notice of site visit will be sent to the Site Supervisor by the end of the day on 4/28/22. Confirmation of receipt is required. Notice of site visit shall be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Director.

>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

LIC809 (FAS) - (06/04)

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