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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270700474
Report Date: 09/10/2024
Date Signed: 09/10/2024 03:09:25 PM

Document Has Been Signed on 09/10/2024 03:09 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:NORTHMINSTER PRESBYTERIAN PRESCHOOL/KINDERPREPFACILITY NUMBER:
270700474
ADMINISTRATOR/
DIRECTOR:		JERRIANNA HAGIOFACILITY TYPE:
850
ADDRESS:315 EAST ALVIN DRIVETELEPHONE:
(831) 449-5676
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 19DATE:
09/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Jerrianna HagioTIME VISIT/
INSPECTION COMPLETED:
03:08 PM
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Licensing Program Analyst (LPA) Elizabeth Larios conducted unannounced Case Management inspection met with Director Jerrianna Bigham. Purpose of today's visit is to assess a civil penalty of $500 for a incident that was self reported to the Department by Director Jerrianna Hagio on August 21, 2024. Type A deficiency was cited on September 4, 2024.

A Notice of Site Visit has been issued and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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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