434414100-8-27-2021-07-CC-MSMS-C6AU5P-20210827151704

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414100
Report Date: 08/27/2021
Date Signed: 08/27/2021 03:17:10 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 EXPLORERS		FACILITY NUMBER:	434414100
ADMINISTRATOR:	DARCY HELLUMS		FACILITY TYPE:	850
ADDRESS:	604 E. EVELYN AVE.		TELEPHONE:	(408) 685-2863
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	45	CENSUS: 20	DATE:	08/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Darcy Hellums & Ann Doan		TIME COMPLETED:	03:45 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	Licensing Program Analysts (LPAs) Mel Matos & Cortney Nelson met with Darcy Hellums, owner/director, and Ann Doan, teacher, for an unannounced Required - 1 year inspection (KIT 2). LPAs toured the Facility both indoor and outdoor areas of the Facility during today's inspection. LPAs notes that the Facility is licensed in Preschool Classroom, Toddler Area, and Art Area. LPAs observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. The Facility has two active waivers on file (playground space and electronic sign in and sign out) and is in compliance with the conditions of both waivers. A review of staff records on August 27, 2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPAs reminded Darcy & Ann 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 violations within a 12 month period. LPAs reviewed ten children's and four staff files (1 director and 3 teachers) during today's inspection Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All staff files reviewed contain the required transcripts/verification of experience/immunization records and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. All staff have current CPR and First Aid certifications on file. Darcy and Ann understand that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips).

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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 EXPLORERS	FACILITY NUMBER: 434414100
	VISIT DATE: 08/27/2021

NARRATIVE

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LPAs observed that the teacher/child ratio was in compliance during today's inspection. Darcy and Ann understand the conditions, limitations, and capacity specifications of the Facility license. Darcy and Ann understand that children shall be visually supervised at all times. LPAs observed 20 napping preschool children with two teachers in the Facility during today's inspection. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director’s office area.

LPAs observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Darcy & Ann state that they and staff clean the Facility Monday through Friday in the evenings. Darcy and Ann understand that the Facility must be kept free of flies and other insects & rodents. LPAs observed that all furniture and equipment is in good condition and safe for the children. Drinking water is readily available for the children in the Facility and in the outdoor playground area via water dispensers/disposable cups/water bottles. LPAs observed solid waste containers with tight-fitting lids in the Facility. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Darcy and Ann state that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Any medications at the Facility are stored in the director's office area.

LPAs observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. Shade is provided by umbrellas and the building overhang in the playground. LPAs observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient materials (rubber padding) in the outdoor playground area. LPAs did not observe any bodies of water.

LPAs conducted an exit interview with Darcy & Ann prior to the conclusion of today's inspection and advised her that 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 Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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