376700974-4-20-2023-20-CC-DSTS-CR3TFG-20230420144132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700974
Report Date: 04/20/2023
Date Signed: 04/20/2023 02:41:39 PM

Document Has Been Signed on 04/20/2023 02:41 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	CREEKSIDE EARLY LEARNING LANGUAGE ACADEMY		FACILITY NUMBER:	376700974
ADMINISTRATOR:	NATALIJA WORRELL		FACILITY TYPE:	850
ADDRESS:	8818 HARBISON CANYON ROAD		TELEPHONE:	(619) 659-8695
CITY:	ALPINE	STATE: CA	ZIP CODE:	91901
CAPACITY:	30	CENSUS: 20	DATE:	04/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Natalija Worrell		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	On 04/20/2023 at 11:25 AM Licensing Program Analyst (LPA) Dana Stevens, conducted an unannounced Annual Inspection and met with Director, Natalija Worrell. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. Twenty children were present on the playground with three staff at the time the inspection. Director stated there are currently 30 children enrolled. Facility operates Monday through Friday 7:30 AM to 04:30 PM. This facility provides care for children ages 3-5 in Rooms 3 and 4. There were no bodies of water observed within the premises. Director stated there are no firearms/weapons on the grounds. Furniture and playground equipment are kept in good condition. The child care center is clean, safe, sanitary, and in good repair at all times to ensure the safety and well-being of children. Facility has a functioning carbon monoxide detector that meets requirements. All toilets and hand washing facilities are safe and working in sanitary conditions. Drinking water is available both indoors and out. Children use individual, refillable water bottles. No food is prepared on site, District office provides refrigerated meals and snacks daily. Menus are posted with a rotating schedule for the year. Facility has a kitchen that is used by staff only. Facility's kitchen and food storage areas are clean and sanitary. Outdoor activity space surface is maintained in a safe condition and free of hazards. All storage containers for solid waste have a tight-fitting covers that are kept on and in good repair. Roster and children and staff files were reviewed and found complete. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana Stevens	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CREEKSIDE EARLY LEARNING LANGUAGE ACADEMY	FACILITY NUMBER: 376700974
	VISIT DATE: 04/20/2023

NARRATIVE

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Staff 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.

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

No deficiencies cited.

Notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana Stevens	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC809 (FAS) - (06/04)

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