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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409020
Report Date: 12/08/2022
Date Signed: 12/08/2022 03:25:38 PM

Document Has Been Signed on 12/08/2022 03:25 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
BAY AREA-CC OAKLAND, 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: 5DATE:
12/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Sharon BrooksTIME COMPLETED:
03:40 PM
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On Thursday, December 8, 2022, at 2:20 PM, Licensing Program Analyst (LPA) Caroline Colson met with Sharon Brooks, Licensee, and Rena Cooks-Pace, her grandmother, for an unannounced increase in capacity inspection. There are four preschool children and one infant present. A health and safety inspection was conducted. Children records were reviewed. Fire Clearance was received. The home is ready to be licensed as a large family day care home.

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: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022
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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