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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614528
Report Date: 07/23/2024
Date Signed: 07/23/2024 03:11:49 PM

Document Has Been Signed on 07/23/2024 03:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KREATIVE KIDS LEARNING CENTERFACILITY NUMBER:
343614528
ADMINISTRATOR/
DIRECTOR:
VAN BUIFACILITY TYPE:
830
ADDRESS:7020 WYNDHAM DR.TELEPHONE:
(916) 689-3777
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 7DATE:
07/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Valerie MorganTIME VISIT/
INSPECTION COMPLETED:
03:25 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative, Valerie Morgan, for an inspection related to an incident at the facility. Purpose of the inspection was explained.

The facility self reported that on June 26, 2024, while playing a child was throwing an item to another child. To prevent the other child from getting hurt, classroom teacher attempted to grab the item from the child's hand. As teacher approached, the child turned the face and the child was hurt with teacher's fingers.

During today's inspection, LPA inspected the facility, observed the child, interviewed the staff that were present at the time of the incident and reviewed the child's records. During the interviews, it was found that the staff attempted to prevent an injury to another child and this child turned the face during the approach, the child was injured accidentally. The child sustain injury between the nose and eye. The child's parent was informed about the incident in timely manner. During today's inspection, LPA did not observe any mark of injury on child's face.

Based on the information collected and the inspection today, no violation of any regulation was observed. LPA answered the licensing regulation questions for the facility representative. Exit interview was conducted. Copy of this report was reviewed and provided to the facility representative.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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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