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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300339
Report Date: 09/19/2023
Date Signed: 09/19/2023 02:39:51 PM

Document Has Been Signed on 09/19/2023 02:39 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CREATIVE LEARNING CENTERFACILITY NUMBER:
376300339
ADMINISTRATOR:HERNANDEZ,MARIAFACILITY TYPE:
850
ADDRESS:650 DOUGLAS DR #101TELEPHONE:
(760) 805-6478
CITY:OCEANSIDESTATE: CAZIP CODE:
92058
CAPACITY: 35TOTAL ENROLLED CHILDREN: 21CENSUS: 21DATE:
09/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Pedro ReyesTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Keely Messerschmidt arrived at the facility on a case management inspection. LPA met with Facility Representative Pedro Reyes, and provided purpose of inspection. At the time of inspection, LPA toured the facility and took census. LPA observed that during this time, the center was operating within ratio and noted that the classrooms were adequately staffed.

LPA Messerschmidt arrived at facility on the purpose of conducting an annual inspection. Upon inspection LPA was notified by Mr. Reyes that the Director had left recently for the day due to a death in her family, and that the Assistant Director was on vacation. LPA was able to speak with Director Maria Hernandez via telephone to confirm that she would not be returning and provide details for the visit. During inspection it was discovered that the keys to access staff and child files were not on site. Unable to access these files LPA Messerschmidt is unable to conduct the annual inspection. This is a potential risk to the health and safety of children in care and therefore a Type B citation will be issued.

An exit interview was conducted with Facility Representative Pedro Reyes and a copy of this report was provided and Appeal Rights were discussed. Notice of Site Visit was provided and must be posted for 30 days from the visit.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2023
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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Document Has Been Signed on 09/19/2023 02:39 PM - It Cannot Be Edited


Created By: Keely Messerschmidt On 09/19/2023 at 02:15 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CREATIVE LEARNING CENTER
FACILITY NUMBER: 376300339

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/29/2023
Section Cited
CCR
101217(d)

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101217 Personnel Records (d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
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Facility Representative agrees to ensure that there are additional keys on site to access files. Proof of completeion will be sent via email to LPA by 9/29/23.
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Based on record review, the licensee did not comply with the section cited above in that staff files were not made available for review during visit, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
09/29/2023
Section Cited
CCR101221(d)

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101221 Child Records (d) All children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements:
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Facility Representative agrees to ensure that there are additional keys on site to access files. Proof of completeion will be sent via email to LPA by 9/29/23.
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This requirement is not met as evidenced by:
Based on record review, the licensee did not comply with the section cited above in that child files were not available during visit, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Deborah Mullen
LICENSING EVALUATOR NAME:Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2023


LIC809 (FAS) - (06/04)
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