384004111-11-8-2023-05-CC-LGOZ-CXDV38-20231108150416

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004111
Report Date: 11/08/2023
Date Signed: 11/08/2023 03:04:23 PM

Document Has Been Signed on 11/08/2023 03:04 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:	384004111
ADMINISTRATOR:	LAU, AGNES		FACILITY TYPE:	830
ADDRESS:	1429 VALENCIA STREET		TELEPHONE:	(415) 577-8389
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 20	CENSUS: 16	DATE:	11/08/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Agnes Lau		TIME COMPLETED:	03:15 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 11/8/2023 at 12:00PM., Licensing Program Analysts, (LPAs) Luis J. Gomez and Jonathan Tse met with Director, Agnes Lau. Purpose of the inspection was explained and is for an Unannounced, Annual/ Random inspection. This is a combination center, with a preschool/ toddler program onsite. Present was the director and 6 staff supervising 16 children. Present staff have criminal record clearances of file. Children had been properly signed in. Infant program utilizes one room: classroom #1, (0- 24 months), and one outdoor play yard. Hours of operation are Monday- Friday, 7:30AM- 6:00PM. Program operates year-round. LPAs inspected facility, indoors and outdoors, for health and safety hazards. At 12:05PM., LPAs observed the following: Infant classroom was clean, orderly, with age-appropriate playthings available for the children. Floors/ ground surfaces were free of obstructions or possible hazards. Accessible furniture and materials inspected were in like-new condition. LPAs observed available storage of children’s belongings. The diaper changing table is located within arm’s reach of a sink. Food preparation area/ sink was located separate, with nearby refrigeration and shelving. Feeding chairs were equipped with a stable (wide) base, with detachable table component. Infant bottles and feeding supplies were correctly stored in refrigerator and properly labeled. Per director, bottles are taken home by the families daily. For napping services, LPA observed several infant cribs and stackable cots. Each infant crib had a tight-fitting sheet and properly sized mattress. Cribs have visibility on all sides for constant staff supervision. Per director, napping sheets are washed on-site daily. Infant classroom had acceptable ventilation and lighting. Trash bins and outlets have been properly covered. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

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: 384004111
	VISIT DATE: 11/08/2023

NARRATIVE

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Detergents, cleaning supplies, and sharp or hazardous objects have been made inaccessible to children. Classroom had a smoke/ carbon monoxide, combination detector, and fully charged fire extinguisher (2A:10BC).

At 12:30PM., LPA inspected the outdoor play area. Area is completely enclosed, with turf padding for added safety. Outdoor play area was free of debris or hazardous plants. Outdoor supplies were in good repair. Per director, for water services, staff provided children with fresh water both inside and outside.

At 12:50PM., LPA reviewed facility records including 5 children’s files and 6 personnel files. Staff files contained the: Notice of Employee Rights (LIC9052); Teacher Qualifications; Personnel Record (LIC701); ‘Mandated Reporter Training’ certifications (AB1207); and Proof of required immunization.

Children’s files were reviewed and included the: Infant Needs and Services Plan, Consent for Medical Treatment (LIC627), Identification of Emergency Information (LIC700), Individual Sleeping Plans (LIC9227) for qualifying infants, Updated Immunization Records; and Admissions Agreement.

Staff are reviewing and documenting infant, napping conditions every 15 minutes. LPA reminded director to ensure staff use initials with completing infant reviewing.

Staff’s CPR/ 1^st Aide Certification was current, expiring: 9/2024.

Emergency disaster drills are being conducted at the facility, with last drill completed on, 10/10/2023, and properly logged.

Required posting were observed in the facility including the: Facility License; Emergency Disaster Plan (LIC610); Seat Beat Safety Laws; Notification of Parent’s Rights (LIC995A). (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

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: 384004111
	VISIT DATE: 11/08/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

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

LPAs discussed safe sleep regulations with the director and discussed Child Care Licensing Safe Sleep webpage at: http://www.cdss.ca.gov/inforesource/child-care-licensing/public-information-and-resouce/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: http://www.cpsc.gov/ and recommend they register all infant devices with the CPSC to be notified of any recalls on their purchased requirement.

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. Director's signature of this form acknowledges receipt of these documents.

This report and rights to comment were discussed. This report must be available in the facility for public review. Notice was given and must remain posted for 30 days. Facility 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: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

LIC809 (FAS) - (06/04)

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