376300340-9-19-2023-10-CC-KMET-CVTTDC-20230919143808

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376300340
Report Date: 09/19/2023
Date Signed: 09/19/2023 02:38:35 PM

Document Has Been Signed on 09/19/2023 02:38 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	CREATIVE LEARNING CENTER		FACILITY NUMBER:	376300340
ADMINISTRATOR:	HERNANDEZ,MARIA		FACILITY TYPE:	830
ADDRESS:	650 DOUGLAS DR #101		TELEPHONE:	(760) 805-6478
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92058
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 12	CENSUS: 8	DATE:	09/19/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Pedro Reyes		TIME COMPLETED:	01:30 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) Keely Messerschmidt arrived at the facility on a case management inspection. LPA met with Facility Representative Pedro Reyes, and provided purpose of inspection. At the time of inspection, LPA toured the facility and took census. LPA observed that during this time, the center was operating within ratio and noted that the classrooms were adequately staffed. LPA Messerschmidt arrived at facility on the purpose of conducting an annual inspection. Upon inspection LPA was notified by Mr. Reyes that the Director had left recently for the day due to a death in her family, and that the Assistant Director was on vacation. LPA was able to speak with Director Maria Hernandez via telephone to confirm that she would not be returning and provide details for the visit. During inspection it was discovered that the keys to access staff and child files were not on site. Unable to access these files LPA Messerschmidt is unable to conduct the annual inspection. This is a potential risk to the health and safety of children in care and therefore a Type B citation will be issued. Also, during the visit LPA verified that all staff have their background clearances and are associated to the license, however, it was found that S1 is not associated to either license. This poses an immediate risk to the health and safety of the children in care and therefore a Type A citation will be issued. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility for the next 12 months.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

Document Has Been Signed on 09/19/2023 02:38 PM - It Cannot Be Edited

Created By: Keely Messerschmidt On 09/19/2023 at 01:22 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CREATIVE LEARNING CENTER	FACILITY NUMBER: 376300340
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

101170(e)

101170 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 2 persons which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 10/19/2023
	Plan of Correction
1 2 3 4	Facility Representative agrees to have S1 obtain her background clearance and be associated to the license. LPA observed Facility Representative Pedro Reyes ask S1 to leave the building until she is cleared to return. Proof of completion will be submitted to LPA via email by 10/19/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Deborah Mullen

LICENSING EVALUATOR NAME:

Keely Messerschmidt

LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

Document Has Been Signed on 09/19/2023 02:38 PM - It Cannot Be Edited

Created By: Keely Messerschmidt On 09/19/2023 at 01:51 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CREATIVE LEARNING CENTER	FACILITY NUMBER: 376300340
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101217(d)

101217 Personnel Records (d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that staff files were not made available for review during visit, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2023
	Plan of Correction
1 2 3 4	Facility Representative agrees to ensure that there are additional keys on site to access files. Proof of completeion will be sent via email to LPA by 9/29/23.

Type B

Section Cited

CCR

101221(d)

101221 Child Records (d) All children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that child files were not available during visit, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2023
	Plan of Correction
1 2 3 4	Facility Representative agrees to ensure that there are additional keys on site to access files. Proof of completeion will be sent via email to LPA by 9/29/23.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Deborah Mullen

LICENSING EVALUATOR NAME:

Keely Messerschmidt

LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CREATIVE LEARNING CENTER	FACILITY NUMBER: 376300340
	VISIT DATE: 09/19/2023

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
26
27
28
29
30
31
32

The Notice of Site Visit and Type A Deficiencies from today’s visit must be posted for 30 days. Failure to keep these posted for the entire 30 days will result in an immediate $100 civil penalty for each.

A Civil Penalty has been assessed on this visit. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

An exit interview was conducted with Facility Representative Pedro Reyes and a copy of this report was provided and Appeal Rights were discussed.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4