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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201244
Report Date: 05/03/2023
Date Signed: 05/03/2023 12:02:18 PM


Document Has Been Signed on 05/03/2023 12:02 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
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612



FACILITY NAME:HOME SWEET WILSONFACILITY NUMBER:
079201244
ADMINISTRATOR:SORIANO, CHRISTINE TFACILITY TYPE:
740
ADDRESS:4248 WILSON LNTELEPHONE:
(510) 507-2679
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:6CENSUS: 5DATE:
05/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Christine Soriano, AdministratorTIME COMPLETED:
12:10 PM
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On 05/03/2023 at 11:40 AM, Licensing Program Analyst (LPA) P. Watson conducted a face to face Component III presentation with Administrator, Christine Soriano.

LPA presented Component III power point and discussed the regulations embodied in the power point. LPAs observed participants gained knowledge about running and maintaining the facility in accordance with regulations.



Exit interview conducted and a copy of report provided.
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 725-7926
LICENSING EVALUATOR NAME: Paris WatsonTELEPHONE: (510) 622-2625
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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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