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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909883
Report Date: 08/27/2019
Date Signed: 08/27/2019 12:07:34 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:
08/27/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Shaina & Jamilah SimsTIME COMPLETED:
01:40 PM
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Licensing Program Analyst (LPA) Caroline Harris conducted a Plan of Correction visit today. LPA met with Shaina and Jamilah Sims.

The purpose of todays visit is to clear deficiencies that were previously cited on 8/13/19. LPA inspected the facility and observed keep out of reach items were out of reach from children, door spinners continued to be placed on off limits rooms and the licensee's had completed the Mandated Reporter training.

During the visit the LPA provided a Letter of Deficiency Citations Cleared. Exit interview was conducted with Shaina and Jamilah Sims.

Per California Code of Regulations Title 22, Division 12, no deficiency was cited during today's visit.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
A Notice of Site Visit was posted on parent board.

To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019
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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