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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409020
Report Date: 08/24/2022
Date Signed: 08/24/2022 11:32:01 AM

Document Has Been Signed on 08/24/2022 11:32 AM - 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:BROOKS, SHARONFACILITY NUMBER:
073409020
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
08/24/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sharon BrooksTIME COMPLETED:
11:46 AM
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On Wednesday, August 24, 2022, at 10:30 AM, Licensing Program Analyst (LPA) Caroline Colson met with Sharon Brooks, Licensee, and Rena Cooks-Pace, her grandmother, for an unannounced case management inspection. There are four preschool children present. The purpose of this inspection is to tour a bedroom and knocked down wall that was previously an Off-Limit area. A licensed contractor renovated the entire bedroom. The new area is safe for the children.

There were no deficiencies cited during this inspection. Exit interview was conducted. Appeal Rights were discussed and given.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2022
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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