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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414100
Report Date: 11/01/2019
Date Signed: 11/01/2019 12:20:17 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 EXPLORERSFACILITY NUMBER:
434414100
ADMINISTRATOR:DARCY HELLUMS & ANN DOANFACILITY TYPE:
850
ADDRESS:604 E. EVELYN AVE.TELEPHONE:
(408) 685-2863
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:45CENSUS: 39DATE:
11/01/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ann DoanTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Mel Matos met with Ann Doan, co-director, for an unannounced case management inspection.

The Facility is in the process of taking over a separate building space located directly across the parking lot from the existing Facility. LPA advised Ann during LPA's previous inspection on July 25, 2019 that the separate building space will require its own separate license since it has a different address than the existing Facility.

Ann states that she and Darcy Hellums (Licensee & co-director) have submitted the pertinent documents to the city of Sunnyvale requesting approval to operate a separate preschool in the separate building located directly across the parking lot from the Facility.
Ann states that the city of Sunnyvale is currently reviewing the proposed project and she is not sure how that process will take. Ann states that upgrades/construction of the interior and playground areas cannot start until the city of Sunnyvale has approved the proposed project.

LPA advised Ann to submit a new application for a child care center license once the proposed project is near final inspection approval and to allow 60-90 days for the entire licensing process. Ann states that she understands the process and will contact LPA Matos if she has any additional questions regarding the new application.

No deficiencies issued during today's inspection.


A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019
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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