<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909883
Report Date: 07/16/2019
Date Signed: 07/16/2019 12:31:30 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SIMS, SHAINA & JAMILAH FAMILY CHILD CAREFACILITY NUMBER:
153909883
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
07/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Shailah & Jamilah SimsTIME COMPLETED:
12:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Caroline Harris conducted an unannounced annual/random inspection. LPA met with Licensees Shailah & Jamilah Sims. LPA conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A)
provided. Licensee has one dog and two cats. Licensee is aware of the safety of children around animals. Licensee takes responsibility for any action taken by pets. There are no "bodies of water" or firearms in this home. Licensee does however use inflatable pools. The LPA observed two inflatable pools on the front driveway area. The licensee is aware that it is a requirement that the pools are drained when not in use. The LPA also observed water tables in the back yard, which the licensee is aware that they also are required to be drained when not in use. LPA observed numerous toys and play rooms available for the children, along with numerous play structures and toys in the back yard. LPA observed that the garage is also being used for children play for only one to two hours a day. Upon inspection of the inside, the LPA observed in the kitchen area, there to be a drawer with sharp knives, weed killer in a lower cabinet and cleaning supplies under the sink that were accessible to children. In the hall bathroom that the children use, there were hair products, facial creams, toothpaste, shampoo, etc that were accessible to children. The "off limits" bedrooms did not have child proof devises or were locked and one bedroom did not have a door knob, making the rooms accessible to children. The LPA also observed the trash can in the kitchen, that had food in it, to not have a lid and a child sitting in a walker. There is no fireplace. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working telephone and the number was verified. Adequate supervision is being provided during this visit. Children are to be supervised when outside in the unfenced play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for the children. Licensee also maintains documentation of immunizations against pertussis, measles and influenza for herself and staff.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SIMS, SHAINA & JAMILAH FAMILY CHILD CARE
FACILITY NUMBER: 153909883
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2019
Section Cited
CCR
102384(a)
1
2
3
4
5
6
7
LICENSING FEES- An applicant or licensee shall be charged fees as specified in Health and Safety Code Section 1596.803: (a) An application fee adjusted by facility and capacity shall be charged by the department for the issuance of an original license to operate a child day care facility. After initial licensure, a fee shall be charged by the
1
2
3
4
5
6
7
Licensee's have agreed to pay the total balance of $109.00, no later than 7/19/19.
8
9
10
11
12
13
14
department annually, on each anniversary of the effective date of the license. A late fee that represents an additional 50 percent of the established annual fee when any licensee fails to pay the annual licensing fee on or before the due date as indicated by postmark on the payment.
8
9
10
11
12
13
14
Type B
07/23/2019
Section Cited
CCR
102417(g)(4)
1
2
3
4
5
6
7
Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children.
1
2
3
4
5
6
7
Licensee's to install safety latches or relocate keep out of reach items and have available for review by the due date of 7/23/19. A return visit will take place to clear this deficiency.
8
9
10
11
12
13
14
This requirement was not met as evidenced by the LPA observations as described on 809 report. This poses a potential Health and Safety risk to children in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SIMS, SHAINA & JAMILAH FAMILY CHILD CARE
FACILITY NUMBER: 153909883
VISIT DATE: 07/16/2019
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. During the annual inspection Licensee stated they will NOT be providing Incidental Medical Services (IMS) at this time.

Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Fire drills are conducted and documented with the date and time every six months. Licensee is aware that children are never to be left in parked vehicles. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Pediatric CPR/First Aid are current and expire on 2/13/21. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Days and hours of operation are Monday – Friday; 7:30 AM – 6:00 PM.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are found u(see next page): 809 D



Exit interview was conducted with Licensee. LPA reviewed with licensee the Mandated Child Abuse Reporter Training, which was due by 3/31/2018. Information was left today which discusses AB 1207 and the website to use. LPA also provided the licensee with information on Safe Sleep requirements and reviewed the regulation changes. Information on Lead Poisoning was also provided to the licensee and she was informed that copies need to be provided to all current parents and any future parents of children enrolled along with posting the information on the parent board. LPA informed licensee about the Community Care Licensing website: www.ccld.ca.gov. and discussed with licensee about the new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Updates that inform licensees of new legislation and regulations. Licensee was advised that forms and updated information may be obtained on the CCLD website and was also advised that it is her responsibility to stay current with regulations.

A copy of this report was provided and discussed along with appeal rights. THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SIMS, SHAINA & JAMILAH FAMILY CHILD CARE
FACILITY NUMBER: 153909883
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/23/2019
Section Cited
CCR
102417(g)
1
2
3
4
5
6
7
OPERATION OF A FAMILY CHILD CARE HOME:
LPA observed "off limits" rooms not having door spinners or being locked and were accessible to children. One "off limits" rooms did not have a door knob. This is a potential threat the health & safety of children in care who could have access to harmful items in those room.
1
2
3
4
5
6
7
Licensee stated she will use spinning plastic door knob covers to make "off limits" rooms inaccessible during day care hours.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SIMS, SHAINA & JAMILAH FAMILY CHILD CARE
FACILITY NUMBER: 153909883
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2019
Section Cited
CCR
102417(d)
1
2
3
4
5
6
7
Operation of a Family Child Care Home. The home shall provide safe toys, play equipment and materials. This requirement is not met as evidenced by the LPA observing an infant sitting in a walker in the living room. This poses a possible risk to the health, safety, or personal rights of children in care.
1
2
3
4
5
6
7
Licensee was informed that walkers are not allowed in the facility. Licensee removed the child from the walker and placed the walker in a dump pile.
Type B
07/23/2019
Section Cited
CCR
1596.8662(b)(1)
1
2
3
4
5
6
7
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
1
2
3
4
5
6
7
Licensee stated that she will take the mandated reporter Training AB 1207 and have available for review by 7/23/19.
8
9
10
11
12
13
14
training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement was not met as evidenced by licensee stating that she was not aware that she needed to take the Mandated Reporter Training AB 1207. This poses a potential health/safety risk to the children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5