343622084-7-18-2019-03-CC-SDLA-BE7T78-20190718142819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622084
Report Date: 07/18/2019
Date Signed: 07/18/2019 02:28:24 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	CREATIVE SPACES PRESCHOOL AND LEARNING CENTER		FACILITY NUMBER:	343622084
ADMINISTRATOR:	MONG, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	5315 H STREET		TELEPHONE:	(916) 307-7109
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95819
CAPACITY:	30	CENSUS: 24	DATE:	07/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Manpreet Thorn and Elizabeth Mong		TIME COMPLETED:	02:45 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 (LPAs) Marea Behvand and Seychelle De Luca met with Licensee Manpreet Thorn and Director Elizabeth Mong for the purpose of an unannounced annual random inspection. Upon arrival, LPA observed 24 napping children supervised by one director and one fully qualified teachers. The program operates Monday through Friday from 7:00 AM to 5:30 PM. LPA toured all activity and classroom spaces (North and South classrooms), restrooms, food service, and an outdoor play area. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, menus, daily schedule, and waiver. LPAs observed a first aid kit. Cleaning disinfectants, hazardous items, and medications are appropriately stored and inaccessible to children. Licensee stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter, all food was protected against contamination, and storage containers with solid waste have tight-fitting covers. Program provides morning and afternoon snacks; parents provide lunches. Drinking water was readily available to children both indoors and outdoors. LPA observed a water cooler and labelled water bottles that are accessible to children. LPA observed full legal signatures while reviewing the sign in and sign out sheet. LPA observed napping cots that are stored in closets on both floors of the facility. LPA observed children's blankets and sheets are stored in labelled plastic containers. LPA observed a sufficient amount of cubbies and chairs. Playground equipment and surfaces are free of loose or sharp parts. There is no climbing structure in the outdoor play area. There are sufficient equipment and toys and shaded areas supplied by overhangs. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: CREATIVE SPACES PRESCHOOL AND LEARNING CENTER	FACILITY NUMBER: 343622084
	VISIT DATE: 07/18/2019

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Four staff and four children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 8/2019). All staff currently employed with the facility have a criminal record clearance, health screening report, and documentation of the educational background, training, and/or experience. There are no firearms or bodies of water on the premises. LPAs observed a functional carbon monoxide detector. LPAs reviewed the Department's inspection authority and discussed with Licensee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

The facility's Plan of Operation is located in the facility file. The program plans to provide Incidental Medical Services and a Plan of Operation is located in the facility file. 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.

LPAs provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Licensee can request to be added to the distribution list to receive Quarterly Updates. This facility evaluation report was reviewed and discussed with Licensee. Licensee was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers. Licensee's signature on this form acknowledges receipt of these rights. No deficiencies were cited during today's inspection.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

LIC809 (FAS) - (06/04)

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