<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417263
Report Date: 05/28/2025
Date Signed: 05/28/2025 12:15:36 PM

Document Has Been Signed on 05/28/2025 12:15 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 JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CREATIVE BEGINNINGS PRESCHOOL-BASCOM SITEFACILITY NUMBER:
434417263
ADMINISTRATOR/
DIRECTOR:		JIA YIFACILITY TYPE:
860
ADDRESS:3229 SOUTH BASCOM AVENUETELEPHONE:
(669) 899-1471
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 0DATE:
05/28/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:02 AM
MET WITH:Jia YiTIME VISIT/
INSPECTION COMPLETED:
12:50 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 5/28/25, Licensing Program Analysts (LPAs) Harsimran Kaur, Janette Cruz and Jaime Gonzalez met with Jia Yi, Applicant representative. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure the health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. This is an application for total of 90 children consisting of 68 preschool children ages 2 years to entry to first grade in classrooms 3,4,5,6, 14 toddlers ages 18 - 36 months in room #2 and 8 infants ages 6 weeks to 24 months in classroom #1. The childcare center will operate Monday - Friday 7:00AM - 7:00 PM. The fire clearance was approved on 05/19/2025. There are no children present at the facility during today's inspection.

LPAs toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 6 classrooms designated for each component.

Preschool Classroom measurements are:

The Indoor total measurements contain a total of {2407.21} square feet, which will accommodate Applicant’s request for 68 preschool children.

Toddler Classroom measurements are:

The Indoor total measurements contain a total of {496.39} square feet, which will accommodate Applicant’s request for 14 toddler children.

Infant Classroom measurements are:

The Indoor total measurements contain a total of {314.55} square feet, which will accommodate Applicant’s request for 8 infant children.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2025
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 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CREATIVE BEGINNINGS PRESCHOOL-BASCOM SITE
FACILITY NUMBER: 434417263
VISIT DATE: 05/28/2025
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
Preschool/toddler shared Outdoor Play measurements are:

Outdoor total measurements contain a total of {2082.28} square feet, which will not accommodate Applicant’s request for preschool children.


Infant outdoor Classroom measurements are:
The Indoor total measurements contain a total of {370.78} square feet, which will not accommodate Applicant’s request for 8 infant children.

Applicant stated that toddlers will be sharing the preschool playground, Applicant will submit a waiver for shared playground use.


LPAs observed all classrooms to be clean, safe, sanitary and in good repair. Facility is located in a building with two floors. The facility will only be licensed to operate in six classrooms located on the first floor. The applicant stated that the second floor will remain inaccessible to children at all times and will be used solely for staff and storage purposes. LPAs observed an open deck area on the second floor. A comfortable temperature for children shall be maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children, including toys, shall be free of toxic substances. All play equipment and materials used by children were observed to be age-appropriate. LPAs observed no fireplace or open face heaters. LPAs observed fully charged fire extinguisher, carbon monoxide and smoke detectors in the facility. There are 86 chairs, 12 tables, 97 cubbies, 54 cots, 7 toilets, 9 sinks, 6 cribs and 2 changing table available for the preschool, toddlers and infants. Staff have separate bathroom located at the second floor that can be utilized by sick children if needed. Sick children will be isolated in the office area of the facility. LPAs observed that items that may pose a danger to children were stored in locked storage rooms inaccessible to children. LPAs observed containers with tight-fitting lids for the disposal of solid wastes. LPAs advised that Applicant maintains first-aid supplies in a location accessible to staff but inaccessible to children.

LPAs observed infant changing table within arms reach to the sink. Applicant stated that parents will provide food and milk bottles for infants. LPAs advised Applicant that as per Title 22 regulations, bottles and dishes provided by authorized representatives shall be rinsed and returned to authorized representatives for sanitizing at the end of each day.

A child who is between 18 months and 36 months of age may participate in the toddler program with written permission from the child's authorized representative. No child in the toddler program shall be placed in the preschool program before the age of 30 months without written permission from the child's authorized representative.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CREATIVE BEGINNINGS PRESCHOOL-BASCOM SITE
FACILITY NUMBER: 434417263
VISIT DATE: 05/28/2025
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
Lunch are provided by parents. Snacks are prepared at the facility. Applicant was advised that full-day programs shall ensure that each child has a lunch and children shall be free to drink as they wish. Drinking water is readily available for the children via water dispenser from filtered water source.

Outdoor area for preschool, toddler and infant children were free of hazards including, holes, broken glass dry grasses, and other debris that pose a fire hazard. Shade was provided by trees. The areas around and under high climbing equipment had cushioned with material (poured rubber) that absorb falls. LPAs observed playground equipment were securely anchored to the ground. The playground is enclosed by a fence at least four feet high to protect children and to keep them in the outdoor activity area. Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. LPAs observed no bodies of water. LPAs observed a landscape playspace adjacent to the preschool yard with uneven ground, which may pose a tripping or falling hazard to children. The Applicant stated that the uneven areas will be filled with tanbark to level the surface and ensure child safety.



Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPAs advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.
Per Written Directive 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 facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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, available at: http://www.ada.gov/childqanda.htm.

Applicant 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.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CREATIVE BEGINNINGS PRESCHOOL-BASCOM SITE
FACILITY NUMBER: 434417263
VISIT DATE: 05/28/2025
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
LPAs discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPAs also informed Applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPAs reviewed with the Applicant LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed before a licensure will be considered.
1. Approval of outdoor shared playground space waivers for all components (must include facility's plan to set up the playground to make preschool climbing equipment inaccessible to toddlers).
2. Proof of uneven areas at the playground will be filled with tanbark to level the surface and ensure child safety.

An exit interview was conducted and a copy of appeal rights and this report was provided to the Applicant Representative, Jia Yi. Final license determination will be made upon review by the Licensing Program Manager.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Harsimran Kaur
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5