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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401949
Report Date: 12/01/2023
Date Signed: 12/01/2023 12:18:55 PM

Document Has Been Signed on 12/01/2023 12:18 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: 95TOTAL ENROLLED CHILDREN: 87CENSUS: 75DATE:
12/01/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Courtney LudlowTIME COMPLETED:
12:30 PM
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On 12/01/2023 at 9:45AM Licensing Program Analysts (LPAs), A. Curry and B. Crass arrived at the facility to conduct an unannounced inspection to follow up on two self-reported unusual incidents at the facility. LPAs toured the facility, reviewed video footage, and conducted interviews with staff and children. No deficiencies are being cited today.

Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Courtney Ludlow.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2023
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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