153909883-10-26-2020-04-CC-AJUZ-BVFMG2-20201117083507

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 153909883
Report Date: 10/21/2020
Date Signed: 10/26/2020 07:45:02 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/15/2020 and conducted by Evaluator Caroline Harris

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20201015103253

FACILITY NAME:	SIMS, SHAINA & JAMILAH FAMILY CHILD CARE		FACILITY NUMBER:	153909883
ADMINISTRATOR:	SIMS, SHAINA & JAMILAH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 548-0072
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93314
CAPACITY:	14	CENSUS: 20	DATE:	10/21/2020
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Shaina Sims		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Provider operating out of ratio.

INVESTIGATION FINDINGS:

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On 10/21/20, an unannounced complaint visit was conducted today by Licensing Program Analyst (LPA) Caroline Harris. LPA met with Licensee, Shaina Sims and two assistants. LPA toured the facility and a census was taken. The purpose of today’s visit was to open the above complaint investigation.

Upon arrival at the home, there were twenty children present. All were two years older or older. Six of the children left to an after school program, putting the facility back within ratio. Based upon observations and interviews conducted, the preponderance of the evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12, Chapter 3, are being cited on the attached LIC 9099D.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 04-CC-20201015103253

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 10/21/2020

NARRATIVE

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Exit interview was conducted with licensee, Shaina Sims. A copy of this report and appeal rights were provided. A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.

The licensee shall post and provide copies of this licensing report to parents/guardians of children in care and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of this report must be given to each enrolled child's parent(s). The licensee was provided a copy of the "Fact Sheet" for AB 633 (Parent Notification Requirements), along with a copy of the relevant documents this date. The licensee must implement the new procedure immediately, by having all parents of enrolled children sign the Acknowledgement of Receipt of Licensing Reports and must retain a copy in each child's file.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020

LIC9099 (FAS) - (06/04)

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Control Number 04-CC-20201015103253

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 10/21/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/26/2020 Section Cited CCR 102416.5(a)	1 2 3 4 5 6 7	Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care can be provided.	1 2 3 4 5 6 7	During the time the LPA was present at the home, six children were taken to an after school program, putting the licensee back into ratio. The LPA reviewed capacity and ratio with the licensee.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by the LPA's observation of there being 20 children present, with the licensee and two assistants, upon arrival at the home. This poses an immediate threat to children in care.	8 9 10 11 12 13 14	The licensee agreed to submit a statement to CCLD, by the given due date of 10/26/20, detailing out what her ratio can be and how she will stay within her capacity at all times.
	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 Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2020

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020

LIC9099 (FAS) - (06/04)

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