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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700527
Report Date: 01/24/2024
Date Signed: 01/24/2024 03:16:11 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/16/2024 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20240116110248

FACILITY NAME:CREATIVE WORLDFACILITY NUMBER:
015700527
ADMINISTRATOR:CHIO, AMANDAFACILITY TYPE:
850
ADDRESS:14830 WASHINGTON AVENUETELEPHONE:
(510) 567-3733
CITY:SAN LEANDROSTATE: CAZIP CODE:
94578
CAPACITY:32CENSUS: 24DATE:
01/24/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Stephanie JosephTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Qualifications - Unqualified staff are left alone with children in care
INVESTIGATION FINDINGS:
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On 1/24/2024 at 9:30am Licensing Program Analyst’s (LPA’s) Morgan Pringle and Christina Uribe met with Director Stephanie Joseph for a complaint that was received against the facility regarding the allegation listed above. LPA’s were met at the entrance of the facility by a staff member, was granted entrance, and introduced to Director. LPA’s informed Director of the nature of the visit. Present during the visit were twenty-four (24) children, eleven (11) toddlers, thirteen (13) preschool age children and five (5) additional staff members.

LPA’s toured the facility for a health and safety inspection of three (3) classrooms, Preschool, Pre-K, and Toddlers. LPA's also obtained facility files, and conducted file reviews.




Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 9
Control Number 52-CC-20240116110248
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CREATIVE WORLD
FACILITY NUMBER: 015700527
VISIT DATE: 01/24/2024
NARRATIVE
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Around 11:30am LPA Pringle entered the Preschool and Toddler classrooms and observed one (1) Teacher and two (2) Teacher's Assistant alone supervising children. Through record review it was found that the staff members did not have proof of qualifications via a transcripts or teaching permits to be left alone, unsupervised, with the children in care.

Deficiency Cited During LPA's visit
  • Unqualified Staff supervising children


LPA's determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 is being cited on the attached LIC 9099D. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in civil penalties.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with Director Stephanie Joseph.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC9099 (FAS) - (06/04)
Page: 8 of 9
Control Number 52-CC-20240116110248
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CREATIVE WORLD
FACILITY NUMBER: 015700527
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/07/2024
Section Cited
CCR
101216.2(e)
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101216.2(e) An aide shall work only under the direct supervision of a teacher.
This requirement was not evidenced met as evidenced by: Through record review and observation it was found that 3 staff members were supervising children alone without direct supervision of a teacher.
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Director will conduct a staff meeting and discuss with facility staff the requirements for staff qualifications and submit to LPA Pringle a sign in sheet with the list of staff present.
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Staff does not have record of transcript or permit on file verifying the ability to be left alone with the children in care. This presents a potential risk to the health and safety of the children in care.
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Director will also send LPA Pringle a statement explaining how the facility will remain in compliance as it pretains to staff qualifications moving forward no later than the due date of 2/07/2024.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC9099 (FAS) - (06/04)
Page: 9 of 9