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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070200186
Report Date: 05/08/2023
Date Signed: 05/08/2023 04:06:59 PM

Document Has Been Signed on 05/08/2023 04:06 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CREATIVE PLAY CENTER, INCFACILITY NUMBER:
070200186
ADMINISTRATOR:CHRIS ABRAHAMFACILITY TYPE:
850
ADDRESS:2323 PLEASANT HILL ROADTELEPHONE:
(925) 932-3173
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 48TOTAL ENROLLED CHILDREN: 57CENSUS: 0DATE:
05/08/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Cory Gillespie/Danielle Gabellini-NewtonTIME COMPLETED:
03:00 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 5/8/23 Licensing Program Analyst (LPA) Monica Mathur met with Co-Directors, Cory Gillespie and Danielle Gabellini-Newton to conduct a Case Management inspection for the Lead Testing results at Center.

LPA conducted an inspection and toured the premises with Director. It was indicated that there was at least one outlet that exceeded the Action Level established by the State for exposure. The outlet is located in the Junior Kindergarten room and was used for drinking water until 2019. Since the results, outlet continues to be out of service and is not being used. Directors state they are using another drinking water outlet, children bring their own water bottles and facility uses Brita filter water. Lead exceedance posed a potential risk to health and safety of children in care. Deficiency is cited on page 809D. LPA discussed a Plan of Correction and facility has submitted the documentation for the post-testing requirements.

Exit interview conducted and report was reviewed with Directors, Cory and Danielle. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2023
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 2
Document Has Been Signed on 05/08/2023 04:06 PM - It Cannot Be Edited


Created By: Monica Mathur On 05/08/2023 at 03:12 PM
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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CREATIVE PLAY CENTER, INC
FACILITY NUMBER: 070200186

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/08/2023
Section Cited

101700.3(b)(2)

1
2
3
4
5
6
7
101700.3(b)(2) Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
By POC due date 6/8/23 Directors agreed to submit a plan of correction.
8
9
10
11
12
13
14
Per inspection, there is 1 outlet which was used for drinking water till 2019 which has lead exceedance, continues to be out of service. This posed a potential risk to health of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Sherelle Johnson
LICENSING EVALUATOR NAME:Monica Mathur
LICENSING EVALUATOR SIGNATURE:
DATE: 05/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/08/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2