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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700527
Report Date: 06/12/2024
Date Signed: 06/12/2024 02:34:39 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
06/10/2024 and conducted by Evaluator Michael Mathew
COMPLAINT CONTROL NUMBER: 52-CC-20240610123607
FACILITY NAME:CREATIVE WORLDFACILITY NUMBER:
015700527
ADMINISTRATOR:BRUMFIELD, AZIZAFACILITY TYPE:
850
ADDRESS:14830 WASHINGTON AVENUETELEPHONE:
(510) 567-3733
CITY:SAN LEANDROSTATE: CAZIP CODE:
94578
CAPACITY:32CENSUS: 26DATE:
06/12/2024
UNANNOUNCEDTIME BEGAN:
08:49 AM
MET WITH:Asia williamsTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
 Staff does not keep facility free from odor.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/12/24 at 8:49 AM Licensing Program Analyst (LPA) Michael Mathew conducted an unannounced inspection for a complaint investigation. LPAs Morgan Pringle and Christina Uribe was present for a case management inspection. LPAs met with facility staff and informed her the purpose of the inspection. Facility staff provided LPA a tour of the facility inside and out. There were 26 children and 3 staff members and 2 miner aids in care at the time of the inspection. At 10 AM LPA was met with owner Essie Day.

Allegation:Staff does not keep facility free from odor. .Based on LPAs interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation of Staff does not keep facility free from odor. is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 Chapter 1 Article 06.section 101223(a)(2) Personal rights, are being cited on the attached LIC 9099D.

cont 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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