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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620521
Report Date: 04/30/2019
Date Signed: 04/30/2019 11:34:48 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 CHILD CARE INC @ MICHIGAN HEIGHTS CHURCHFACILITY NUMBER:
393620521
ADMINISTRATOR:SAVINA GAINESFACILITY TYPE:
850
ADDRESS:3156 MICHIGAN AVENUETELEPHONE:
(209) 941-9100
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:38CENSUS: 15DATE:
04/30/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Veronica Gonzalez TIME COMPLETED:
11:41 AM
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Licensing Program Analyst (LPA) Stacey Williams arrived at the facility for the purpose of conducting a plan of correction (POC) inspection for deficiencies cited on March 22, 2019. LPA met with Director Veronica Gonzalez. LPA conducted a tour of the facility and observed fifteen children present and supervised by 4 staff. LPA observed classroom #1 and classroom #2. New area rugs were purchased for classroom #2. Director informed LPA the carpet and all rugs in both classroom #1 and classroom #2 will be professionally cleaned on May 2, 2019.

LPA generated a POC letter for the Director during today's inspection.

There were no deficiencies cited during today's inspection.

A notice of site of visit was provided and an exit interview was conducted.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 229-4549
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2019
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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