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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490102569
Report Date: 09/22/2022
Date Signed: 09/22/2022 03:14:35 PM

Document Has Been Signed on 09/22/2022 03:14 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:GAN ISRAEL PRESCHOOLFACILITY NUMBER:
490102569
ADMINISTRATOR:TERI PORTERFACILITY TYPE:
850
ADDRESS:740 WESTERN AVENUETELEPHONE:
(707) 763-5136
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 12DATE:
09/22/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Teri PorterTIME COMPLETED:
03:30 PM
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LPA Ouye met with Director, Teri Porter to provide consultation for the toddler option at her preschool program. The center has 3 classroom where is currently has three age groups. The director is determining if the toddler option can be added in the future.
LPA measured each room.
There is a toddler room which can support 8 children, There is a great room which has a room divider. The smaller section can support 19 children and the larger section of the room supports 23 children.

LPA Ouye advised the director that the maximum group size for toddler is 12 children. The toddlers must have their own toilet and sink that is not used by preschool age children. LPA provided the director with the preschool/toddler regulation and health and safety code for informational purpose.

The outdoor area is sufficient to support the toddlers with the exception of the play structure. LPA advised the director that a rotational waiver could be approved as long as the toddlers and the preschool children are not commingled and when the toddlers are using the outdoor activity area the play structure would need to be made inaccessible.

The director would need to updated their admission agreement and parent handbook to add toddler information as specified in the supplied regulation and health and safety code if they are to move forward with adding the toddler option.

No deficiencies cited during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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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