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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490111834
Report Date: 10/16/2023
Date Signed: 10/16/2023 01:32:57 PM


Document Has Been Signed on 10/16/2023 01:32 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:BROOKS EXTENDED CHILD CAREFACILITY NUMBER:
490111834
ADMINISTRATOR:JASON RIGGSFACILITY TYPE:
840
ADDRESS:750 NATALIE DRIVETELEPHONE:
(707) 838-3540
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY:96CENSUS: 0DATE:
10/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:32 PM
MET WITH:N/ATIME COMPLETED:
12:48 PM
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A confirmation of closure visit to the facility was made by Licensing Program Analyst (LPA) Y. Yang.The facility's licensee, Extended Child Care Coalition of Sonoma County, Inc submitted a request to close the facility on 10/12/23. Per the facility's executive director, Jason Riggs, the facility has ceased all operations as of June 2023. During today's case management visit, the LPA observed no children in care. A license exempt after school program operated by the Windsor Unified School District now occupies the building. This facility was located on the Brooks Elementary School premises.

Confirmation of facility closure is complete.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023
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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