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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405365
Report Date: 10/15/2021
Date Signed: 10/15/2021 11:46:04 AM

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:COOPER, JESUSA JFACILITY NUMBER:
073405365
ADMINISTRATOR:COOPER, JESUSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 726-9118
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY:14CENSUS: 7DATE:
10/15/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:02 AM
MET WITH:Jesusa (Jeanette) Cooper TIME COMPLETED:
11:55 AM
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On 10/15/21 at 11:02am, Licensing Program Analyst (LPA) Catherine Fernandes arrived to the home and met with Licensee Jesusa (Jeanette) Cooper on a case management inspection. Present during the inspection was one infant, six preschoolers and two additional finger print cleared staff members.

The cause for the inspection was to add three bedrooms to the on limit areas of her day care.

LPA Fernandes did a walk through of the two bedrooms on the right side of the hallway and the bedroom near the kitchen.


The three bedrooms were inspected and are now licensed and are ready for use.



No deficiencies were issued during todays inspection.


Appeal Rights and Report provided
Notice of site visit needs to be posted for 30 days.

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021
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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