434400501-10-3-2019-07-CC-SYIP-BGLVKE-20191003163012

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400501
Report Date: 10/03/2019
Date Signed: 10/03/2019 04:30:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CREATIVE PLAY LEARNING CENTER		FACILITY NUMBER:	434400501
ADMINISTRATOR:	NASIATKA, JULIE		FACILITY TYPE:	850
ADDRESS:	95 FOURTH STREET		TELEPHONE:	(408) 846-9551
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY:	59	CENSUS: 12	DATE:	10/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:48 PM
MET WITH:	Julie Nasiatka		TIME COMPLETED:	04:40 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 (LPAs) Samantha Yip and Nancy Rodriguez conducted an unannounced annual random inspection. LPAs met with Angela Lopez and explained the reason for the inspection. Director Julie Nasiatka arrived shortly after. Upon arrival, there were 12 preschool children and 2 staff present. The teacher child ratio was observed to be in compliance during today's inspection. LPA reviewed the sign in/sign out sheet. License, Notification of Parent's Rights, and Emergency Disaster Plan was observed to be posted. LPA toured in the inside and outside of the facility. Facility was observed to be clean and sanitary. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible to children. The furniture and the equipment, such as tables, chair, and napping mats were age-appropriate and in good condition. The floors were clean and free of tripping hazard. LPA observed there is sufficient amount of age-appropriate toys for children in care. Restrooms for children’s use were observed to be safe, sanitary, and in functioning condition. Storage containers for waste have tight fitted lids. Director stated that there are no weapons stored on the premise. LPA observed a fully charged fire extinguisher, functioning smoke detector, and carbon monoxide detector. The outdoor activity area is fenced. Play equipment were observed to be in good condition. Areas around play equipment have resilient material to absorb falls. LPA discussed with Director about monitoring play equipment for any cracks. Shaded rest area is provided through canopy. LPA did not observe any bodies of water during today's inspection. Facility does provide snacks to the children in care. Area to prepare and store snacks was observed to be clean and sanitary. All meals are prepared and brought from home. Drinking water is provided through Brita and cups. ---------------------continues on 809 dated 10/03/2019 page 1---------------------------------------

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CREATIVE PLAY LEARNING CENTER	FACILITY NUMBER: 434400501
	VISIT DATE: 10/03/2019

NARRATIVE

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10 children’s files were reviewed during today’s inspection. The records reviewed include not limited to parent's rights.

3 staff files were reviewed during today's inspection. The records reviewed include education credit, Mandated Reporter training, and immunization records for measles, pertussis, and influenza. LPA discussed with Director about Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years. Mandated Reported Training can be accessed at http://www.mandatedreporterca.com. There is currently at least one staff on site with a valid CPR/1st Aid, which expires on 08/2021

Staff present during the inspection have cleared criminal record and child abuse index clearance or exemption. LPA also reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

Director stated that she currently does have children in care who requires Incidental Medical Services (IMS) services. Medication is properly stored where it is out of the reach of children and with the proper documents. 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.

Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online Licensing Forms, Adoption of new Laws, etc.

No deficiencies were cited as a result of today's inspection. An exit interview was conducted, where this report was discussed and provided to Director.

A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC809 (FAS) - (06/04)

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