393621652-3-2-2020-53-CC-CBAY-BMBRGM-20200302120100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393621652
Report Date: 03/02/2020
Date Signed: 03/02/2020 12:01:05 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 CHILD CARE - COUNTRY CLUB		FACILITY NUMBER:	393621652
ADMINISTRATOR:	EISON, DEBRA		FACILITY TYPE:	850
ADDRESS:	2448 COUNTRY CLUB BLVD		TELEPHONE:	(209) 941-9100
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95204
CAPACITY:	72	CENSUS: 60	DATE:	03/02/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Mallory Misasi		TIME COMPLETED:	12:00 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 Analysts (LPA) Charlotte Baney met with Director Mallory Misasi for the purpose of an unannounced annual inspection. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Upon arrival, LPA observed sixty preschool children and eight staff members. Facility hours of operation are Monday through Friday from 6:30 AM to 6:00 PM. LPA toured all activity and classroom spaces, restrooms, and outdoor play areas. Medications are stored appropriately and inaccessible to children . Director stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with bark to absorb the fall. Toileting facilities are in safe, sanitary, and operating condition.

The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers. Facility provides breakfast, lunch and afternoon snacks. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA observed full legal signatures while reviewing the sign in and sign out sheet.

Staff and 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.

Staff currently employed with the facility have a health screening report, documentation of the educational background, training, and/or experience, immunization records, and AB 1207 Mandated Reporter certificates. LPA reminded Director that 100% supervision is required at all times, including in the bathroom. There are no firearms or bodies of water on the premises.

continued on C page.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Charlotte Baney	TELEPHONE: (916) 216-7791
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

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 2

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 CHILD CARE - COUNTRY CLUB	FACILITY NUMBER: 393621652
	VISIT DATE: 03/02/2020

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
26
27
28
29
30
31
32

LPA observed a functional carbon monoxide detector. LPA reviewed the Department's inspection authority and discussed with Director 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.

LPA verified the annual fees are current. This facility evaluation report was reviewed and discussed with Director. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Director 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 child care centers. LPA provided and discussed the Lead Exposure brochure. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the licensee can request to be added to the distribution list to receive Quarterly Updates.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Charlotte Baney	TELEPHONE: (916) 216-7791
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2