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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 01:01:32 PM


Document Has Been Signed on 02/18/2022 01:01 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:20CENSUS: 0DATE:
02/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Tatiana HillmanTIME COMPLETED:
01:15 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. The center operates Monday - Friday 7:00am to 6:00pm. The center has only one classrooms: Jungle Babies (Room 3).
LPA inspected the infant day care area for health and safety hazards today. The center is clean, orderly and in good repair. There are no pools, spas or other similar bodies of water on site. Per director, there are no firearms or weapons on site. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. All furniture and equipment are clean and in good working condition. The center's furniture and equipment are age appropriate. There is a sufficient quantity of tables and chairs as well as changing tables to meet the capacity. Parents provide bedding for matts. Bedding is sent home once a week for cleaning by parents while matts are wiped down and disinfected daily.

Water bottles, food, and other items provided by the parents are labeled and stored appropriately. Food is provided by parents. The changing table is within an arm’s reach of a sink. The center has a working carbon monoxide detector. The outdoor play area designated for the toddlers is clean and in good repair. All toys and equipment are in working condition. Areas under slides and other high climbing equipment is adequately cushioned poured rubber. Per director, toys are cleaned nightly.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 PRESCHOOL
FACILITY NUMBER: 414004546
VISIT DATE: 02/18/2022
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At 9:30 AM, Staff files were reviewed. At 9:33, LPA observed that staff members were not associated to the facility. LPA observed that paperwork was not completed correctly for association. LPA issued a technical violation this day. At 9: 38 AM, LPA observed that staff member did not have current Mandated Reporter Training. A Technical Violation is issued. All staff have criminal record clearances on file. Education units are on file for teaching staff. At least one staff member on site has current CPR/First Aid certification. Children's files were reviewed. Children's files are complete with all required Licensing documents.


LPA discussed the use of Guardian with site director. LPA discussed teacher qualifications, proper room arrangement, staff files, and CPR certification with site director.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
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
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: TERRA NOVA CHRISTIAN PRESCHOOL
FACILITY NUMBER: 414004546
VISIT DATE: 02/18/2022
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LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed site director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

Exit interview conducted and report was reviewed with the site director Tatiana Hillman.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

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.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
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
LIC809 (FAS) - (06/04)
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