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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010176
Report Date: 03/17/2023
Date Signed: 03/17/2023 02:44:20 PM

Document Has Been Signed on 03/17/2023 02:44 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NORTHGATE CHRISTIAN FELLOWSHIP - PRESCHOOLFACILITY NUMBER:
483010176
ADMINISTRATOR:AMANDA VERBISFACILITY TYPE:
850
ADDRESS:2201 LAKE HERMAN ROADTELEPHONE:
(707) 315-7124
CITY:BENICIASTATE: CAZIP CODE:
94510
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: DATE:
03/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:17 PM
MET WITH:Amanda VerbvisTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Childcare Preschool Director, Amanda Verbis to review the preschool classroom near the two infant classroom. The Director and LPA discussed the room being changed to a toddler room by adding the toddler component to the preschool license.
The Director believes that she would have 12 toddlers in the room. There are two sinks and one toilet for the toddler children.

To add the toddler component, the director would need to submit:
-LIC200A adding the toddler capacity of 12 toddler and 63 preschool children, total capacity remains at 75 children.
-There would be no fire clearance required and no fee.
-The facility would also need to submit an updated parent handbook showing the different ages served. They must identify the toddler ages served (between 18 to 36 months) in their toddler program.
-The preschool age will likely remain at two years old through entry into first grade.
-The parents must also approve in writing that their child will enter the toddler option and that a child cannot be moved out the the toddler option before 30 months of age without parental consent.
-Teachers working in the toddler options are required to have completed three infant units prior to starting as a teacher in the toddler age class.
-A job description must be submitted for the toddler teacher to be added to the staff handbook.
-The license will also have to submit a waiver request to the department to use the infant outdoor area on a shared rational basis with the infant program.

No deficiencies cited during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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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