214005536-5-28-2021-05-CC-HRCO-C3FVSG-20210528164131

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005536
Report Date: 05/25/2021
Date Signed: 05/28/2021 04:41:37 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CREATIVE GARDENS		FACILITY NUMBER:	214005536
ADMINISTRATOR:	LI, WEI CHRISTOPHER		FACILITY TYPE:	850
ADDRESS:	120 DONAHUE STREET		TELEPHONE:	(415) 577-8389
CITY:	SAUSALITO	STATE: CA	ZIP CODE:	94965
CAPACITY:	75	CENSUS: 0	DATE:	05/25/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Wei Christopher Li		TIME COMPLETED:	02:45 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 Analyst (LPA) Haydee Caliboso met with applicant Wei Christopher Li, today for a pre-licensing inspection. The applicant has requested a combination of a preschool program with a toddler component program. The preschool program will be part of a combination center as the applicant has also applied for infant license for 28 children (ages birth to 18 months) at the same location. The applicant has requested 24 toddler, ages 18 months – 36 months, and 51 preschool children, ages 3 to Kindergarten. The facility plans to operate Monday - Friday; 7:30 AM to 6:30 PM. The designated Site Supervisor for the facility will be Wei Christopher Li. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. This inspection included a technical assistance inspection for COVID-19 guidance and support. Indoor: There are 3 classrooms designated for the preschool program and 2 classrooms for the toddler program. The following square footage was calculated for each preschool classroom: classroom (#5) was calculated for 617.4 sq. ft, allowing for a capacity of 17 children, classroom (#6) was calculated for 658 sq. ft, allowing for a capacity of 18 children, classroom (#7) was calculated for 655 sq. ft, allowing for a capacity of 18 children. The following square footage was calculated for each toddler classroom: toddler classroom (#1) was calculated for 601 sq. ft, allowing for a capacity of 14 children, toddler classroom (#2) was calculated for 602.2 sq. ft, allowing for a capacity of 14 children. The classrooms and furniture equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. There is storage space for children's personal belongings and cots to be utilized for napping children. The parents will provide a sheet and blanket for the children. Bedding is sent home to be washed once a week or as needed. The classrooms are equipped with fire extinguisher, smoke and carbon monoxide detectors, and garbage cans with tight-fitting lids. The facility is adequately ventilated and free of insects and bugs. The facility has first aid kit in each classroom and a designated backpack with emergency supplies. Cont. 809-C pg. 2

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CREATIVE GARDENS	FACILITY NUMBER: 214005536
	VISIT DATE: 05/25/2021

NARRATIVE

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Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. The facility has a designated kitchen area where food is prepared, a working refrigerator, and a working dishwasher where utensils are to be cleaned. The parents will provide lunch daily to the children. The program will provide morning and afternoon snacks daily.

Each of the 3 preschool classrooms has 2 toilets and 2 sinks available for children to use. Each of the 2 toddler classrooms has 1 toilet, 1 sink, and 1 diaper changing table area. The restroom is clean and do not have any health or safety hazards. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children. Isolation area for ill children is in the site supervisor office, and staff bathrooms will be used for ill children. There is designated restroom for staff to use. Pitchers of water and disposable cups will be provided and for indoor and outdoor use.Children in the program will be signed in and out daily by parents using an electronic signature. The facility will conduct and log fire drills once every six months, and the log will be available upon request.

Outdoor: The preschool outdoor area measures a total of 2,500 sq. ft. allowing for a total of 33 children. No more than 33 children may be in the play area at a time. The facility will provide a letter request for a waiver for scheduled outdoor rotation usage. The facility’s outdoor playground is enclosed and gated approximately 10 ft. tall. The outdoor space was observed to be clean, safe, and equipped with climbing structure that is age-appropriate for preschool children. The outdoor space playground has green turf for cushion. LPA advised that each program is to be separated at all times and are not allowed to use the outdoor area simultaneously.

The following items were reviewed as part of today’s visit: Record keeping for staff, children, and facility records, care and supervision of the children, child discipline procedures – staff will use positive discipline. Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements.
Cont. 809-C pg. 3

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CREATIVE GARDENS	FACILITY NUMBER: 214005536
	VISIT DATE: 05/25/2021

NARRATIVE

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An electronic copy of this three-page report was emailed to Weil Christopher Li. Applicant was asked to review the report and return a signed copy of the report to LPA Haydee Caliboso. COVID-19 Self-assessment guide was received and reviewed today with the Director.

The following corrections need to be submitted and further reviewed:
· Ample age appropriate outdoor toys for preschool and toddler program.
· LIC 404

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of this facility for a total capacity of 75. The following is required prior to licensure:

· Letter request for a waiver for scheduled outdoor rotation usage for preschool and toddler children.
· Revised LIC 200A

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

LIC809 (FAS) - (06/04)

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