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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700337
Report Date: 02/19/2020
Date Signed: 02/19/2020 12:30:21 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:EASTGATE CHRISTIAN SCHOOLFACILITY NUMBER:
376700337
ADMINISTRATOR:TANTIANI BUDIMANFACILITY TYPE:
850
ADDRESS:4377 EASTGATE MALLTELEPHONE:
8584537430
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY:132CENSUS: 97DATE:
02/19/2020
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director Tantiani BudimanTIME COMPLETED:
12:40 PM
NARRATIVE
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On 2/19/20 @ 9:30 AM Licensing Program Analyst (LPA's) Tresha Souza and Yolanda Baez arrived at the facility to conduct an annual random inspection. Upon arrival LPA's met with Director Tantiani Budiman . The following ratios were observed:

Room 1 (Serves children 3-4 years old):

  • There were 12 children present with 1 staff member
Room 3 (Serves children 4-5 years old):
  • There were 15 children present with 2 staff members
Room 4 (Serves children 3-4 years old):
  • There were 15 children present with 2 staff members
Room 5 (Serves children 4-5 years old):
  • There were 9 children present with 1 staff members
Room 6 (Serves children 4-5 years old)):
  • There were 6 children present with 1 staff members
Room 7 (Serves children 2 1/2-3 1/2 years old):
  • There were 12 children present with 1 staff members
Room 8 (Serves children 2 1/2 - 3 1/2 years old):
  • There were 9 children present with 2 staff members
Room 9 (Serves children 2 years old):
  • There were 10 children present with 2 staff members
Room 10 (Serves children 3-4 years old):
  • There were 9 children present with 2 staff members
...CONTINUED ON 809C...
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha SouzaTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: EASTGATE CHRISTIAN SCHOOL
FACILITY NUMBER: 376700337
VISIT DATE: 02/19/2020
NARRATIVE
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Furniture and age appropriate equipment is in good condition indoors. After touring the playgrounds LPA's noticed that playground #1 had a crack in the Little Tykes playhouse and playground 3 needs to have sand refilled around the entire playground due to several gaps including under play structures with slides and climbing areas. All classrooms are clean. Classroom #1 has a door leading to the main street and does not lock from inside allowing children to open and exit freely. Classroom #9 has laundry room inside the classroom. LPA's advised Director to make laundry room inaccessible to avoid potential incidents/risks to children in care. Snacks and lunches are prepared on site and menus are posted. Drinking water is readily accessible inside of the classroom through the use of Water Jugs and sippy cups brought from home. Children have access to water outside of the classroom through a water fountain. All disinfectants, solutions, and other hazardous items are inaccessible to children through latches and locks. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, and are in good repair. The outdoor play area is fenced and the area has trees an canopies used for shade. There are no bodies of water or weapons at this facility. The last emergency drill was conducted on 01/12/20. There is an operational smoke detector and carbon monoxide detector at the facility. First Aid/CPR was reviewed and is in compliance. Staff records were reviewed. Children's records were reviewed and are in compliance.

Immunization law (SB792) was discussed with Director and she understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility and available for review for: pertussis, measles, and influenza. Facility is compliant with SB792.



...CONTINUED ON 809C...

SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha SouzaTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: EASTGATE CHRISTIAN SCHOOL
FACILITY NUMBER: 376700337
VISIT DATE: 02/19/2020
NARRATIVE
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LPA's discussed the Mandated Reporter training, AB1207. LPA's reminded Director that all staff members are to take the training and have the printed certificates present at the facility and available for review. Facility is not in compliance with AB1207, see 809D for cited deficiencies.

LPA's reviewed the following with Director: IMS, SIDS, Car seat Law, Shaken Baby Syndrome, the updated CDPH 286 form for "Pre-Kindergarten and School Immunization Record" and Director stated that she understands. This facility does provide Incidental Medical Services- IMS. There are children enrolled that have IMS and an IMS plan of operation is already on file. The following information regarding ADA was provided, US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and http://www.ada.gov/childqanda.htm. LPA's and Director discussed California Megan's Law and LPA's provided: www.meganslaw.ca.gov.

NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA's observed the posting the Notice of Site Visit.

Duty Line: (619) 767-2248, Monday through Friday from 8am to 5pm. To access our Regulation and Forms please use our WEBSITE: http://ccld.ca.gov

An Exit interview was conducted.

SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha SouzaTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: EASTGATE CHRISTIAN SCHOOL
FACILITY NUMBER: 376700337
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/18/2020
Section Cited

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101238.2 (e)(1) Outdoor Activity Space As a condition of licensure, the areas around and under...equipment, swings, slides... shall be cushioned with material that absorbs falls.
Sand, woodchips and peagravel, or... produced for the purposes of (e) above, are permitted. Thiis requirement is not met as evidence by:
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LPA's obserations. LPA's observed gaps at bottom of slide and climbing structure and throughout playyard in playground #3
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Type B
03/18/2020
Section Cited

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ยง1596.8662(2)(b)(1)Availability of information ... training for mandated reporter... proof of completion. On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care...shall complete the mandated reporter training provided... shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidence by:
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LPA's staff file review. 3 staff certificates were expired and 1 was an incorrect certificate.
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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: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha SouzaTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 02/19/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2020
LIC809 (FAS) - (06/04)
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