414004881-10-12-2023-05-CC-LGOZ-CWJR3S-20231012124022

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004881
Report Date: 10/12/2023
Date Signed: 10/12/2023 12:40:32 PM

Document Has Been Signed on 10/12/2023 12:40 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 LEARNING CENTER, LLC		FACILITY NUMBER:	414004881
ADMINISTRATOR:	ALBARAKAT, NOOR		FACILITY TYPE:	850
ADDRESS:	815 ALLERTON STREET		TELEPHONE:	(669) 243-8381
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94063
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 14	DATE:	10/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Noor Albarakat		TIME COMPLETED:	12:45 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 10/12/2023 at 9:15AM., Licensing Program Analysts (LPAs), Luis J. Gomez and Man Tso met with Director, Noor Albarakat. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. Facility is licensed to operate two preschool-age classrooms. Present was the director and 6 staff supervising 14 children. Children present had been properly signed in. Staff presents have criminal record clearances on file. Program utilizes two classrooms: Room #1 (103), #2 (105), and one, Outdoor Play Area. Per Director, program operates year-around. LPA inspected facility, indoors and outdoors, with director for health and safety hazards. At 9:30AM., LPAs observed the following: Classrooms were clean, orderly, with age-appropriate playthings available for the children. Floor/ground surfaces were free of any obstructions or possible hazards. Hangers are available for storage of children's belongings. Accessible furniture, puzzles, books, and supplies were free of sharp corners or splinters. Classrooms were equipped with child- sized tables and chairs for seated activities. Children’s bathrooms are maintained clean with fixtures (2 toilets, 2 sinks) in operating condition. Diaper changing table is available to staff. Per director, area is disinfected after each use. Staff bathroom is located separate. For napping services, stackable cots are stored in classroom #2. LPA observed napping cots were made from cleanable material. Per Director, napping sheets are washed every week. Facility has acceptable ventilation and lighting. Electrical outlets and trash bins have been covered installed. Classroom has testable carbon monoxide combination detector, telephone, and several fully charged fire extinguishers: 2A:10BC. First aid kit reviewed is fully stocked. At 9:50AM, LPAs inspected the outdoor play area. Area was completely enclosed with absorbent material installed around play structure. Per director, sandbox remains covered, and is reviewed daily by staff for foreign objects. Play structures was properly anchored and shaded resting area was available for the children. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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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Document Has Been Signed on 10/12/2023 12:40 PM - It Cannot Be Edited

Created By: Luis Gomez On 10/12/2023 at 11:12 AM

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

FACILITY NAME: CREATIVE LEARNING CENTER, LLC	FACILITY NUMBER: 414004881
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

100700(c)(1)

Written Directives for Lead Testing

(1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	At 10:20AM., Based on record review and interview, LPAs confirmed facility's fixtures used for drinking water, and/ or food preparation have not been tested for lead contamination levels. This poses a potential health and safety risk to children in care.
	POC Due Date: 10/23/2023
	Plan of Correction
1 2 3 4	Director will have water outlets tested for lead contamination by the due date: 10/23/2023. Proof of correction will be submitted to the department via email.

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:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Luis Gomez

LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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 LEARNING CENTER, LLC	FACILITY NUMBER: 414004881
	VISIT DATE: 10/12/2023

NARRATIVE

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(Page 2)
At 9:55AM., Based on observations, LPAs confirmed handles for two bikes missing/ damaged in outdoor play area. Director removed playthings during inspection. Advisory Note: Technical Violation (LIC9102TV) was issued.

During inspection, LPAs reviewed food preparation/storage area. Food items inspected had been properly stored and were current. Food preparation area was observed clean and free of trash or rubbish.

At 10:15AM LPAs reviewed facility records including 5 children’s files and 7 personnel files. Staff’s files contained the: Notice of Employee Rights (LIC9052); Education Verification; Personnel Record (LIC501); and Required Proof of Immunization.

LPAs reminded director to ensure all staff complete the required “Mandated Reporter Training’ (AB1207). Advisory Note: Technical Assistance (LIC9102TA) was issued.

Staff's ‘Cardiopulmonary Resuscitation and First Aid’ certifications on file were current, expiring: 5/2024.

Children’s files contained the: Consent for Emergency Medical Treatment (LIC627); Immunization Records, Identification and Emergency Information (LIC700); Personal Rights (LIC613A); and Notification of Parent’s Rights (LIC995).

At 10:20AM., Based on record review and interview, LPAs confirmed facility's fixtures used for drinking water, and/ or food preparation have not been tested for lead contamination levels.

Emergency disaster drill are conducted monthly. Last drill completed on 10/5/2023. LPAs reminded facility log disaster drills conducted on-site.

LPAs 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 (PUB369).

Incidental Medical Services (IMS) policy was discussed. 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/. (REFER 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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 LEARNING CENTER, LLC	FACILITY NUMBER: 414004881
	VISIT DATE: 10/12/2023

NARRATIVE

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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.

LPAs referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on 809D. Exit interview, appeal rights and report was discussed with Director, Noor Alberakat 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 provided 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: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC809 (FAS) - (06/04)

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