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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015600148
Report Date: 03/06/2025
Date Signed: 03/06/2025 03:11:25 PM

Document Has Been Signed on 03/06/2025 03:11 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, STE. 310
OAKLAND, CA 94612
FACILITY NAME:ROSEGATEFACILITY NUMBER:
015600148
ADMINISTRATOR/
DIRECTOR:		LEUNG, BELINDAFACILITY TYPE:
740
ADDRESS:1345 CLARKE STREETTELEPHONE:
(510) 483-0150
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 40TOTAL ENROLLED CHILDREN: 0CENSUS: 30DATE:
03/06/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Jeffrey Tong, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 03/06/2025 at 02:00 PM Licensing Program Analysts (LPAs) J. Clancy-Czuleger and Y. Brown arrived unannounced to conduct a Case Management. LPAs met with Jeffrey Tong, Administrator.

LPAs came to discuss the number of showers present at the facility and what alterations will be needed to accommodate their current capacity of residents and what will be needed for a change of ownership.

The facility was informed that they will need to obtain building permits from city/county and submit them to CCLD will a letter of explanation that includes a expected timeline of construction, how the facility will accommodate the residents during construction, along with an updated floor plan. Once construction has been completed the facility will contact CCLD to inspect the new bathroom.

Exit interview conducted. A copy of this report and appeal rights provided.
Harpreet HumpalTELEPHONE: (510) 285-3928
Jill Clancy-CzulegerTELEPHONE: 510-286-4201
DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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