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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004110
Report Date: 09/17/2024
Date Signed: 09/17/2024 03:49:48 PM

Document Has Been Signed on 09/17/2024 03:49 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 GARDENSFACILITY NUMBER:
384004110
ADMINISTRATOR/
DIRECTOR:
LAU, AGNESFACILITY TYPE:
850
ADDRESS:1429 VALENCIA STREETTELEPHONE:
(415) 577-8389
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 38DATE:
09/17/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Agnes Lau TIME VISIT/
INSPECTION COMPLETED:
04:05 PM
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On 9/17/2024 at 2:20PM., Licensing Program Analyst (LPA) Luis Gomez met with Coordinator, Nina Johnson. The purpose of today’s inspection was explained and was for an unannounced, plan of correction inspection. Program Director, Agnes Lau arrived during inspection. Present was the director and 9 staff supervising 38 children. Children present had been signed-in by guardians. LPA inspected facility for health and safety hazards.

During inspection, LPA conducted record review, observation, and interview.
At 2:30PM., LPA observed qualified teacher in classrooms T1, P2, and P1.

On 9/5/2024, Director submitted updated personnel report with staff schedule (LIC500). Personnel Report submitted shows qualified teachers present in preschool classrooms during operating hours (7:30AM- 6:00PM). Per director, classrooms P1 and P2, will combine at the end of the day, allowing qualified teacher to rotate into toddler classroom (T1), if needed.

Per director, staff S3 has been assigned as an ‘Assistant Teacher’. Per director, until proper teacher qualifications are met, S3 will not be left alone with children.

Deficiencies issued on 8/28/2024, have been cleared, and ‘Cleared Plan of Correction Letter’ was provided.

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

This report must be available in facility for public review. Notice of site visit was provided and shall remain posted for 30 days. Director was advised for questions to contact the Regional Office, Mon- Fri, 8:00am-5:00pm, 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: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2024
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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