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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408868
Report Date: 02/16/2022
Date Signed: 02/16/2022 02:12:30 PM

Document Has Been Signed on 02/16/2022 02:12 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 YILADIM PRESCHOOLFACILITY NUMBER:
073408868
ADMINISTRATOR:BERKOWITZ, CHAYAFACILITY TYPE:
830
ADDRESS:1671 NEWELL AVENUETELEPHONE:
(925) 937-4101
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY: 9TOTAL ENROLLED CHILDREN: 7CENSUS: 6DATE:
02/16/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Chaya BerkowitzTIME COMPLETED:
01:30 PM
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On 2/16/22 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Case Management inspection and met with Director, Chaya Berkowitz. LPA explained the purpose of today's inspection which is to follow up on an incident self reported by the Center.

On 1/11/22 an infant woke up after a nap gasping for breath. Emergency services were called. Child was required to be taken to the hospital and the condition improved. Facility took all precautions and actions to provide medical attention and followed protocol for medical treatment.

No deficiency was cited. An exit interview was conducted with Director, Chaya Berkowitz. A Notice of Site Visit was issued.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2022
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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