Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420906
Report Date: 01/14/2016
Date Signed 01/14/2016 12:49:24 PM

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:LITTLE FLOWERS MONTESSORIFACILITY NUMBER:
013420906
ADMINISTRATOR:MAHAJAN, GAURIFACILITY TYPE:
850
ADDRESS:4343 STEVENSON BLVDTELEPHONE:
(510) 651-0515
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:100CENSUS: 82DATE:
01/14/2016
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:DIRECTOR G MAHAJANTIME COMPLETED:
01:00 PM
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LPA AL WONG RETURNED TO THIS PRESCHOOL CENTER TO COMPLETE THE STAFF & CHILDREN FILES REVIEW STARTED ON THE RANDOM ANNUAL INSPECTION VISIT OF 1/6/16.

LPA COMPLETED THE REVIEW OF THE FILES.



LPA REQUESTED THAT THE DIRECTOR CHECK LICENSING'S WEBSITE AT WWW.CCLD.CA.GOV FOR THE QUARTERLY UPDATES REGARDING LAW & REGULATION CHANGES.




THERE ARE NO DEFICIENCIES CITED TODAY.
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Al WongTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2016
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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