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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547203430
Report Date: 07/19/2022
Date Signed: 07/19/2022 12:03:05 PM

Document Has Been Signed on 07/19/2022 12:03 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:CREATIVE CENTER, THEFACILITY NUMBER:
547203430
ADMINISTRATOR:GLICK, TIMOTHY J.FACILITY TYPE:
775
ADDRESS:410 E. RACE STREETTELEPHONE:
(559) 733-9329
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 115CENSUS: 60DATE:
07/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Program Director Timothy "Joel Glick and Program Manager Celeste ChavezTIME COMPLETED:
12:15 PM
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Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Program Manager Celeste Chavez and discussed the purpose of the visit. Program Director Timothy "Joel Glick and Program Manager Celeste Chavez began the tour at the front entrance of the facility.

Visitor log-in/temperature check, masks and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available for clients and visitors. Social distancing is maintained in common areas. Hand washing and other various Covid 19 related signs were observed in the common areas. Facility is operating with minimal clients in person in facility. Facility is also operating through zoom meetings.

Cleaning supplies were observed behind a locked storage room door. LPA observed the following personal protective equipment in office; hand sanitizer, gown, face shield, gloves and masks. Staff records were reviewed for infection control training. LPA observed all facility staff wearing masks. Client files have updated emergency contact information.

No deficiencies were observed.

Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
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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