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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004546
Report Date: 02/18/2022
Date Signed: 02/18/2022 01:07:05 PM

Document Has Been Signed on 02/18/2022 01:07 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:TERRA NOVA CHRISTIAN PRESCHOOLFACILITY NUMBER:
414004546
ADMINISTRATOR:TATIANA HILLMANFACILITY TYPE:
830
ADDRESS:1125 TERRA NOVA BLVD.TELEPHONE:
(650) 355-2962
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY: 20TOTAL ENROLLED CHILDREN: 7CENSUS: 0DATE:
02/18/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Tatiana HillmanTIME COMPLETED:
01:20 PM
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On February 18, 2022 at 8:40 AM, Licensing Program Analyst (LPA) Cowan met with Site Director, Tatiana Hillman, for an unannounced annual random inspection. Present today is director and two staff. There are no children present this day. The facility has chosen this day to clean and organize the facility. This is a subsequent visit to inspect the fence for the new play structure for toddlers. LPA observed that the new fence is sturdy and bolted to the ground. On this day, LPA approves the use of facility’s new play structure for infants.

Copy of this report was reviewed and will be emailed to the director, Tatiana Hillman at TERRANOVACHRISTIANPRESCHOOL@GMAIL.COM by the close of business on 2/18/22. Confirmation of receipt is required. Signed copy of this report will be stored in the facility file.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2022
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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