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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010210219
Report Date: 04/11/2024
Date Signed: 04/11/2024 10:36:12 AM

Document Has Been Signed on 04/11/2024 10:36 AM - 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:GAN MAH TOV PRESCHOOLFACILITY NUMBER:
010210219
ADMINISTRATOR/
DIRECTOR:		NEELY, JULIAFACILITY TYPE:
850
ADDRESS:3778 PARK BOULEVARDTELEPHONE:
(949) 378-7167
CITY:OAKLANDSTATE: CAZIP CODE:
94610
CAPACITY: 40TOTAL ENROLLED CHILDREN: 27CENSUS: 27DATE:
04/11/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Julia NeelyTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
NARRATIVE
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On 04/11/2024 at 9:00 AM Licensing Program Analyst (LPA), A. Curry conducted an announced case management visit to inspect the upstairs Social Hall. LPA met with the Director, Julia Neely, to explain the purpose of today's visit. LPA toured the facility. LPA did not observe any health or safety concerns. The upstairs Social Hall will now be on limits effective today, 04/11/2024. No deficiencies are being cited today.

Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Julia Neely.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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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