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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201470
Report Date: 02/13/2025
Date Signed: 02/13/2025 12:07:32 PM

Document Has Been Signed on 02/13/2025 12:07 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:PEOPLE'S CARE FREMONT PEAKFACILITY NUMBER:
079201470
ADMINISTRATOR/
DIRECTOR:		HALIBURTON, TIMOTHYFACILITY TYPE:
735
ADDRESS:433 FREMONT PEAK DRTELEPHONE:
(909) 287-3557
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 4CENSUS: 3DATE:
02/13/2025
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:LICENSEE SHARON HAUN/ ADMINISTRATOR TIMOTHY HALIBURTON TIME VISIT/
INSPECTION COMPLETED:
12:16 PM
NARRATIVE
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On 02/13/2025 at 11:30AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted a face-to-face Component III presentation on 02/13/2025 starting at 11:30am. LPA conducted Component III with Licensee, Sharon Han and Administrator, Timothy Haliburton.

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


Exit interview conducted and a copy of report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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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