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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623141
Report Date: 05/22/2019
Date Signed: 05/22/2019 11:44:40 AM

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 SPIRIT LEARNING CENTERFACILITY NUMBER:
343623141
ADMINISTRATOR:BRANN, NICOLEFACILITY TYPE:
850
ADDRESS:10729 FAIR OAKS BLVDTELEPHONE:
(916) 967-7883
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:24CENSUS: 19DATE:
05/22/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Aubrey Green and Nicole BrannTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Seychelle De Luca and Associate Governmental Program Analyst (AGPA) Larissa Juarez met with Applicants Aubrey Green and Nicole Brann for the purpose of an announced pre-licensing, change of ownership inspection. Applicants currently have a preschool license under a partnership (#343620671), and are changing to an LLC. Applicants request a preschool license to serve 24 preschool children from two to six years of age. The program will operate Monday through Friday from 9:00 AM to 12:00 PM and Monday, Wednesday, and Friday from 12:45 PM and 3:45 PM. Applicants acknowledge that school-age children may not be present during preschool hours of operation.

LPA and AGPA provided LIC311A. Applicants acknowledge that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, and daily schedule. LPA and AGPA discussed the forms that must be in each child's and each staff member's file. LPA and AGPA observed the sign in and sign out binders. Parents will provide morning and afternoon snacks. Lunch and naps are not provided as this facility has two part day programs.

INDOOR ACTIVITY SPACE:
LPA and AGPA observed age appropriate equipment and toys for preschool children. There is a small refrigerator, a microwave, and a sink in the kitchen. Medications will be kept in the kitchen in an area that is inaccessible to children. Snacks provided by parents will be stored in the kitchen and Applicants acknowledge that the facility must have additional provisions on site. There are two first aid kits that will be kept in the kitchen and children's bathroom. LPA and AGPA observed cleaning disinfectants stored in a locked cabinet in the kitchen. Applicants stated there are no poisons on the premises. LPA and AGPA observed there is a sufficient amount of cubbies. LPA and AGPA observed water is readily available to children.

Report continues on 809-C.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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 SPIRIT LEARNING CENTER
FACILITY NUMBER: 343623141
VISIT DATE: 05/22/2019
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LPA and AGPA did not take any measurements during today's inspection. LPA used the measurements taken on 1/22/2016 under the current license's pre-licensing report. The classrooms contain a total of 844.86 square feet, which will accommodate Applicants' request for 24 preschool children. There are two toilets and three sinks for the children and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one main outdoor area on the property. The outdoor play area is fenced with a chain link fence on two sides and a wooden fence on the remainder; the fences are at least four feet tall. There are no firearms or bodies of water on the premises. There are shaded areas supplied by trees and overhangs.

LPA and AGPA did not take any measurements during today's inspection. LPA used the measurements taken on 1/22/2016 under the current license's pre-licensing report. The outdoor play area contains a total of 3267.13 square feet, which will accommodate Applicants' request for 24 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). LPA and AGPA observed water is readily available to children outdoors.

Incidental Medical Services 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.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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 SPIRIT LEARNING CENTER
FACILITY NUMBER: 343623141
VISIT DATE: 05/22/2019
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LPA and AGPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; criminal record clearances; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA and AGPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Applicants can request to be added to the distribution list to receive Quarterly Updates.

This facility evaluation report was reviewed and discussed with Applicants. Applicants were encouraged to 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.

CONDITIONS REQUIRING CORRECTION PRIOR TO ISSUING A LICENSE:


1. A final review of the file by LPM Roxana Saravia.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3