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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002445
Report Date: 09/21/2022
Date Signed: 09/21/2022 03:45:45 PM


Document Has Been Signed on 09/21/2022 03:45 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:GAN NOE PRESCHOOLFACILITY NUMBER:
384002445
ADMINISTRATOR:POTASH, LEAHFACILITY TYPE:
850
ADDRESS:3781 CESAR CHAVEZ STREETTELEPHONE:
(415) 648-8000
CITY:SAN FRNCISCOSTATE: CAZIP CODE:
94110
CAPACITY:30CENSUS: 20DATE:
09/21/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Leah Potash TIME COMPLETED:
04:00 PM
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On 9/21/2022 at 2:50PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Director, Leah Potash. Purpose of the inspection was explained and was for an unannounced; Plan of Correction inspection. Present was the director and three staff supervising for 20 children. Children present have been properly signed in. LPA inspected facility, inside and outside, for health and safety hazards.

During today’s inspection, LPA performed observations, reviewed facility records and interviewed director.

At 3:10PM., LPA observed alcohol bottles have been removed from day-care storage cabinet. Facility was free of hazards or dangerous conditions.

Signed, LIC9224, Acknowledgement of Receipt of Licensing Report, have stored in the children’s files. LPA reminded licensee to ensure registering families sign the required, LIC9224, prior to enrollment for 12 months.

Deficiency issued on 9/12/2022, have been cleared and ‘Cleared Plan of Correction Letter’ was provided.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with licensee, Leah Potash and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Principal was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2022
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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