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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401949
Report Date: 10/19/2022
Date Signed: 10/19/2022 04:05:53 PM


Document Has Been Signed on 10/19/2022 04:05 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:GAN ILAN PRESCHOOL - TEMPLE ISAIAHFACILITY NUMBER:
073401949
ADMINISTRATOR:COURTNEY LUDLOWFACILITY TYPE:
850
ADDRESS:945 RISA ROADTELEPHONE:
(925) 284-8453
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:95CENSUS: DATE:
10/19/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:LUDLOW, COURTNEYTIME COMPLETED:
02:45 PM
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Licensing Program Manager (LPM) Mayla Mendoza and Licensing Program Analyst (LPA) Nyeesha Blount met with Director Courtney Ludlow for an informal meeting at the Oakland Child Care Regional Office. The purpose of the meeting was to discuss personal rights, an incident that occurred where a child was grabbed by a teacher leaving fingerprints on her arm.

The incident was reported to Community Care Licensing (CCL).

“Proof of staff Training on Personal Rights has been received by CCL.

Ms. Ludlow was reminded to report incidents to CCL.


Ms. Ludlow provided proof of completing personal rights training with staff by 09/30/22.


Exit interview conducted and report was reviewed with the Director Courtney Ludlow.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha BlountTELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022
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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