Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313616885
Report Date: 01/08/2016
Date Signed 01/08/2016 02:43:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:GAN YELADIM JEWISH PRESCHOOLFACILITY NUMBER:
313616885
ADMINISTRATOR:KORIK, MALKAFACILITY TYPE:
850
ADDRESS:4410 DOUGLAS BLVD.TELEPHONE:
(916) 677-9960
CITY:GRANITE BAYSTATE: CAZIP CODE:
95746
CAPACITY:15CENSUS: 2DATE:
01/08/2016
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Isroel and Malka KorikTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Steven Lunn made a Case Management visit today and met with Licensee Malka Korik. There were no children in care today except for the licensee's own two children. The facilities last day of operation was on 12/24/2015, prior to the winter break. Licensee is requesting to increase her capacity by the addition of a second toilet in the facility.

Based on the prelicensing visit dated 01/25/2012, facility was licensed for 15 children due to having only one toilet and one sink for the preschool and toddler option at that time.

LPA observed the installation and remodel of the restroom facilities. There are now two toilets and two sink. Fire clearance was approved on 09/02/2011 for a total capacity of 21.

Based on the addition to the restroom facilities, the capacity for the facility will now be 21. Facility is today, licensed to serve children ages 2 to entry into first grade including the toddler option which can serve children ages 18-30 months.

TOTAL CAPACITY MAY NOT EXCEED 21 CHILDREN AT ANY TIME.

LPA will issue an updated license upon return to the office.
SUPERVISOR'S NAME: Jennifer BrekkeTELEPHONE: (916) 263-5717
LICENSING EVALUATOR NAME: Steven LunnTELEPHONE: 916-216-7798
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2016
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1