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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201228
Report Date: 03/17/2025
Date Signed: 03/17/2025 02:15:56 PM

Document Has Been Signed on 03/17/2025 02:15 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:LITTLE FLOWERFACILITY NUMBER:
019201228
ADMINISTRATOR/
DIRECTOR:		CALINGASAN, MARY ANGELINEFACILITY TYPE:
735
ADDRESS:3731 MONTEREY BLVDTELEPHONE:
(510) 878-7218
CITY:SAN LEANDROSTATE: CAZIP CODE:
94578
CAPACITY: 6CENSUS: 0DATE:
03/17/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:LPA met with Staff, Mercidite CalingasanTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 03/17/25 at 1:40 pm Licensing Program Analysts (LPA) A. Gomez arrived unannounced to do an annual inspection. LPA met with Staff, Mercidite Calingasan and explained the purpose of the visit. Administrator, Mary Calingasan was unavailable and approved staff to sign the report. There are currently no clients.

LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Dinner and silver wares were observed sufficient for residents' use. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. LPA observed that the facility does not currently have any residents at this time.

The Administrator is aware and agrees to contact LPA to do a walk through visit, prior to any residents moving in.


No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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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