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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004546
Report Date: 01/09/2023
Date Signed: 01/09/2023 12:23:48 PM


Document Has Been Signed on 01/09/2023 12:23 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: 6DATE:
01/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Catherine Kirkpatrick / Tatiana HillmanTIME COMPLETED:
11:48 AM
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On January 9, 2023 at 10:00 AM, Licensing Program Analyst (LPA) Cowan met with Lead Teacher, Catherine Kirkpatrick, for an unannounced 1-Year Required inspection. Present at this time is Lead Teacher, 2 staff, and 6 infants in care. Director, Tatiana Hillman, is not present when LPA arrived. Director arrived at 10:52 AM to complete the inspection with LPA. Staff to child ratio was met on this day. The center operates Monday - Friday 7:00am to 6:00pm. The center has only one classrooms: Jungle Babies (Room 3). When LPA arrived children were participating in a craft project.
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 cribs, table/chairs and changing tables meet the capacity. Parents provide bedding for cribs and mats. Bedding is sent home once a week for cleaning by parents while cribs and mates are wiped down and disinfected daily. Bottles and other items provided by the parents are labeled and stored appropriately. Food is provided by parents. Changing tables are within an arm’s reach of a sink. The center has a working carbon monoxide detector. All solid waste storage containers have secure lids. The outdoor play area designated for the infants and toddlers was clean and in good repair. All toys and equipment are in working condition. Per director, toys are cleaned nightly. Areas under slides and other high climbing equipment is adequately cushioned poured rubber.

At 10:30 AM, facility files were reviewed. LPA reviewed 5 children's staff files and 2 staff's files. Both children's and staff's files were complete with all required Licensing documents. All required postings are posted. LPA observed facility's electronic sign in/out. Facility has updated Child Care Roster on file.


Report Continues ...

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2023
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 2


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: 01/09/2023
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

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.

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 licensee [facility representative] 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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

An exit interview conducted and report was reviewed with site director.

This report must be available in the facility for public review. Notice of site visit is to be posted for 30 days. 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

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023
LIC809 (FAS) - (06/04)
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