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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909883
Report Date: 01/21/2020
Date Signed: 01/21/2020 11:27:22 AM

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:SIMS, SHAINA & JAMILAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 548-0072
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY:14CENSUS: 14DATE:
01/21/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Shaina & Jamilah SimsTIME COMPLETED:
11:35 AM
NARRATIVE
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An unannounced Case Management inspection was conducted today by Licensing Program Analyst (LPA) Caroline Harris. LPA met with licensees, Shaina and Jamilah Sims, Also present was their assistant. A tour of the facility inside and outside was made. There were fourteen day-care children present. The purpose of today's visit was to conduct a post licensing, increase in capacity follow-up, on the initial increase of capacity visit that took place on 9/5/19. The areas of the home that day care children have access to are the living room, dining room, kitchen, bedroom #1 and hall bathroom. Off-limits rooms are made inaccessible by child safety plastic door knobs. Operable fire extinguisher, smoke alarm, carbon monoxide detector, and first aid kit are in place. There are no "bodies of water" or weapons, in this home. Licensee does have one dog and two cats. Children's files were reviewed. A child roster is maintained and required forms are posted. Licensee was advised that forms and updated information may be obtained on the CCLD website (www.ccld.ca.gov). Licensee was also advised that it is her responsibility to stay current with regulations. Days and hours of operation are Monday – Friday; 7:30 AM – 6:00 PM.

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. LPA also left information on Safe Sleep requirements and required forms and reviewed the regulation changes.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today. Exit interview was conducted with licensee.

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: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
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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