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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700337
Report Date: 06/19/2020
Date Signed: 06/19/2020 03:56:42 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:
(858) 453-7430
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY:132CENSUS: DATE:
06/19/2020
TYPE OF VISIT:Case Management - Legal/Non-complianceANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Tantiana BudimanTIME COMPLETED:
03:00 PM
NARRATIVE
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On 6/19/20 at 1:30 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an announced case management non-compliance tele-inspection due to COVID-19 State of Emergency (SOE) via FaceTime with the Director Tantiani Budiman. The following ratios were observed:

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


· There were 3 children present with 2 staff members: Anisa Zoelle, Joanna Seibert
Room 3 (Serves children 4-5 years old):
· There were 4 children present with 2 staff members: Claudia Ma, Silah Bustos
Room 4 (Serves children 3-4 years old):
· There were 4 children present with 2 staff members: Julia Cecil, Tiffani Krupinski
Room 6 (Serves children 4-5 years old):
· There were 5 children present with 2 staff members: Charlotte McFarland, Jennifer Killion
Room 7 (Serves children 2 1/2-3 years old):
· There were 3 children present with 2 staff members: Janina Falo-Tauanuu, Rachael Stewart
Room 9 (Serves children 2 years old):
· There were 5 children present with 2 staff members: Yolanda Polanco-Woorich & Sarah Duron.
Room 10 (Serves children 3-4 years old):
· There were 3 children present with 2 staff members: Michelle Titus & Marcella Chavez
Appropriate ratios and capacity were observed.
Teacher Michelle Titus was not associated to the facility. Director submitted transfer request to have her associated. (Continued on LIC809-C)
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2020
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: 06/19/2020
NARRATIVE
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Furniture and age appropriate equipment is in good condition indoors and outdoors. Children's toilets and hand washing facilities are sanitary. Food preparation area is clean, food and beverages are stored in covered containers below 45 degrees F and storage containers for solid waste are covered. Drinking water is readily accessible inside and outside the classroom. All disinfectants, cleaning solutions, and other hazardous items are inaccessible to children through latches and locks. Outdoor play area is fenced with adequate material for cushioning. Area has canopies/trees used for shade. There are no bodies of water or weapons at this facility. No excluded individuals are present. Last fire drill was conducted and documented on 6/18/20. There is an operational carbon monoxide detector at the facility located in the director's office. Sign in/sign out sheets are well maintained. No records were reviewed at this time. LPA requested a copy of the Personnel Report (LIC500), Children’s roster (LIC9040), Emergency Disaster Plan (LIC610) and updated Administrative Organization (LIC309) be sent via e-mail. Menus are posted. LPA also requested an Unusual Incident Report (LIC624) be sent via e-mail for when the facility closed and re-opened as a precaution due to COVID-19.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPAs provided Director with updated COVID-19 resources and set up a technical assistance tele-visit regarding COVID-19 guidelines for 6/23/20. LPA reminded Director that corporal punishment and smoking are not allowed in the day care. The Director was also reminded to keep all items that read “keep out of reach of children” physically inaccessible to children in care and all equipment that is used should be used only as intended by the manufacturer.

(Continued on LIC809-C page 3)
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2020
LIC809 (FAS) - (06/04)
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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: 06/19/2020
NARRATIVE
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Facility representatives were advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information.
Duty Line was provided: (619) 767-2248. LPA also discussed California Megan's Law and LPA provided Director with the following website: www.meganslaw.ca.gov

Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiency was cited (refer to LIC 809-D). CIVIL PENALTIES were assessed in the amount of $500. Licensee was e-mailed a copy of Civil Penalties Assessment LIC421BG.


An exit interview was conducted with the Director. All requirements of the Non-Compliance Conference dated 6/19/2018 have been met and all required documentation is in the facility file. A Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) will be sent along with the report (LIC809) and (LIC421BG) via e-mail to the Licensee. Licensee will confirm receipt of this report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. The Notice of Site Visit (LIC9213) must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2020
LIC809 (FAS) - (06/04)
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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: 06/19/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2020
Section Cited

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101170 Criminal Record Clearance (e) All individuals subject to a criminal record review...shall prior to working…in a licensed facility: (2) Request a transfer of a criminal record clearance.
This requirement was not met as evidenced by…
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Based on review of staff associations, licensee did not associate Michelle Titus to the facility, which poses a potential health and safety 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:
DATE: 06/19/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2020
LIC809 (FAS) - (06/04)
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