013418996-1-28-2025-02-CC-MDOY-DDCS5F-20250128123413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013418996
Report Date: 01/28/2025
Date Signed: 01/28/2025 12:34:22 PM

Document Has Been Signed on 01/28/2025 12:34 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	CONGREGATION NETIVOT SHALOM		FACILITY NUMBER:	013418996
ADMINISTRATOR/ DIRECTOR:	KAREN LLAMAS		FACILITY TYPE:	850
ADDRESS:	1316 UNIVERSITY AVE.		TELEPHONE:	(510) 549-9447
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94702
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 10	DATE:	01/28/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:50 AM
MET WITH:	Karen IIamas		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 28, 2025, Licensing Program Analyst, (LPA) M. Domantay met with Director Karen IIamas for the purpose of a case management inspection. Applicant requests to add a Toddler Program to the existing Preschool license to serve 22 Preschool children from ages 2 years to first grade entry and 8 toddlers ages 18-36 months. The program will operate Monday through Thursday from 8:00 a.m. to 5:30 p.m and Friday 8:00a.m to 4:30p.m. The fire clearance was granted and approved on 12/5/2023, updated request granted on 7/8/2024 from the Berkeley Fire Department. The facility does not provide food, all food is provided from families. OUTDOOR ACTIVITY SPACE: There is 1 designated toddler outdoor area and 1 designated preschool outdoor area. The preschool and toddler outdoor play areas is fenced with a wooden fencing in the preschool play yard and concrete/brick wall, and metal gate in the toddler play yard that is at least four feet tall. There is a a wooden play area with stairs and a slide on the preschool play yard that was built specifically for the facility per Director. LPA did not observe a manufacturer sticker on the play structure. LPA notified Director that wooden play area can be inspected by a playground inspector to determine age range. Preschool play areas are surrounded by mats and sand and toddler play yard has turf as cushioning to cushion a child's fall. LPA observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. LPA reminded Director to ensure to empty all water tables when not in use. There is sufficient shading areas provided by trees and canopies in the play yards. LPA measured the preschool outdoor activity space. The Preschool outdoor play area contains a total of 2071.17 square feet, which will accommodate preschool capacity of 22 preschool children. LPA measured the Toddler outdoor activity space. The Toddler outdoor play area contains a total of 690.49 square feet, which will accommodate Applicant's request for 8 toddler children. Page 1

Mai Lor	TELEPHONE: (916) 491-0182
Melissa Domantay	TELEPHONE: (510) 725-7021
	DATE: 01/28/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CONGREGATION NETIVOT SHALOM	FACILITY NUMBER: 013418996
	VISIT DATE: 01/28/2025

NARRATIVE

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Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

LPA discussed 100% supervision is always required in all areas that children have access to including the
bathroom. Personal Rights, inspection authority, reporting requirements, maintaining buildings and grounds
was reviewed. Staff Qualifications, Staff to Children’s ratios and Capacity was explained to ensure
compliance. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director’s absence must be reported to the department within 10 working days.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and
stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other
important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information
website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Director, Karen IIamas.

The following items are required before a license will be issued:

1. Regional Manager (RM) final file review.

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SUPERVISOR'S NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC809 (FAS) - (06/04)

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