384004110-11-6-2023-05-CC-LGOZ-CXC27U-20231106160917

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004110
Report Date: 11/06/2023
Date Signed: 11/06/2023 04:09:28 PM

Document Has Been Signed on 11/06/2023 04:09 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CREATIVE GARDENS		FACILITY NUMBER:	384004110
ADMINISTRATOR:	LAU, AGNES		FACILITY TYPE:	850
ADDRESS:	1429 VALENCIA STREET		TELEPHONE:	(415) 577-8389
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 56	TOTAL ENROLLED CHILDREN: 56	CENSUS: 36	DATE:	11/06/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Nina Johnson, Agnes Lau		TIME COMPLETED:	04:15 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	On 11/6/2023 at 12:40PM., Licensing Program Analyst (LPA), Luis J. Gomez met with Program Coordinator, Nina Johnson. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. Facility is licensed to operate a preschool-age program with toddler option. Director, Agnes Lau arrived during inspection. Present was the director and 10 staff supervising 36 children. Children present had been properly signed in. Staff’s criminal record clearances are on file. Program utilizes three classrooms: Toddler (18-36 months); Preschool #1 (2- 3 years old); and Preschool #2 (3- 5 years old), and one, shared outdoor play yard. Per director, preschool program operates year around. LPA inspected facility, indoors and outdoors, for health and safety hazards. At 12:55PM., the following was observed: Classrooms were clean, orderly, with age-appropriate playthings and items available for the children. Floor/ ground surfaces were clear of obstacles or potential hazards. Storage cubbies are available for children's belongings. Children’s books, art supplies, and puzzles inspected were free of sharp corners or splinters. Classrooms were equipped with child- sized tables and chairs. Children’s bathrooms were maintained clean, with fixtures in operating condition. Staff bathroom is located separate. For napping services, stackable cots are stored in each classroom. Napping cots were made of a cleanable material. Per Director, children napping supplies are washed weekly by families. Facility was ventilation and lighting. Trash bins and outlets have coverings installed. Classrooms had smoke/ carbon monoxide combination detectors, functioning telephone, and fire extinguishers: 3A:40BC in hallway. Facility’s first aid kit was reviewed and was fully stocked. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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

FACILITY NAME: CREATIVE GARDENS	FACILITY NUMBER: 384004110
	VISIT DATE: 11/06/2023

NARRATIVE

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At 1:30PM., LPA inspected the outdoor play area. Area was completely enclosed, with toys and playthings available for the children. Absorbent material had been installed around climbing structure. Sand box had covering installed, and was free of any foreign objects.

LPA reminded director to remove all broken/ damaged play items from outdoor play area. Advisory Note: Technical Violation (LIC9102TV) was issued.

During inspection, LPA reviewed food preparation/storage room. Food items inspected had been properly stored. Area was observed clean and without trash or rubbish.

At 1:50PM LPA reviewed facility records including 5 children’s files and 8 personnel files. Children’s files were reviewed and contained the: Consent for Emergency Medical Treatment (LIC627); Immunization Records, Identification and Emergency Information (LIC700); Personal Rights (LIC613A); Notification of Parent’s Rights (LIC995); and ‘Written Medical Assessments’.

Facility staff is conducting and documenting, infant napping check for qualifying children in toddler classroom.

Staff’s files were reviewed and contained the: Notice of Employee Rights (LIC9052); Proof of required Immunization; ‘Mandated Reporter Training (Ab1207); Teacher Qualifications; and Personnel Record (LIC501).

Staff’s updated CPR/ 1^st aid certification was on file, expiring on: 2/25/2025.
Emergency disaster drill are conducted monthly, with last drill completed on 10/16/2023, properly logged.

LPA observed required posting in facility, including the: Facility License; Emergency Disaster Plan (LIC610); Earthquake Preparedness Checklist; Notification of Parent’s Rights (PUB394); Updated Snack Menu; and Child Passenger Safety Laws (PUB269). (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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

FACILITY NAME: CREATIVE GARDENS	FACILITY NUMBER: 384004110
	VISIT DATE: 11/06/2023

NARRATIVE

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For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

LPA referred Director to the Department website regarding Lead: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Based on today's inspection, no deficiencies were cited in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations. Exit interview and report was discussed with Director, Agnes Lau signature of this form acknowledges receipt of these documents.

This report must be made available in the facility for public review. Notice of site visit was given and must remain posted for 30 days. Director was advised any additional questions to call office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

LIC809 (FAS) - (06/04)

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