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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153909883
Report Date: 11/16/2020
Date Signed: 11/16/2020 12:58:01 PM



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 CAREFACILITY NUMBER:
153909883
ADMINISTRATOR:SIMS, SHAINA & JAMILAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 548-0072
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY:14CENSUS: 0DATE:
11/16/2020
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Shaina, Jamilah & Dasia SimsTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Daycare child sustained injury while in care.

Un-fingerprinted Adults in home during day care hours.
INVESTIGATION FINDINGS:
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On 11/16/20, Licensing Program Analyst (LPA) Caroline Harris conducted an office visit with licensee's Shaina, Jamiah and Dasia Sims. The LPA reviewed the above listed allegations with the licensee's. The purpose of today’s visit was to close the complaint investigation. The investigation consisted of interviews with the licensee's and parents, as well as a facility records review and documentation.

Based upon information and interviews conducted, the preponderance of the evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12, Chapter 3, are being cited on the attached LIC 9099-D. "Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months." Child Care Parent Notification Requirements LIC 9224 was provided and discussed (LIC 9224 -Acknowledgement of Receipt of Licensing Reports).

An exit interview was conducted with licensee's Shaina, Jamilah and Dasia Sims. A copy of this report was provided to the licensee's.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
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: 11/16/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/16/2020
Section Cited
CCR
102370(d)(1)
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Criminal Record Clearance. All individuals subject to a criminal record review as specified in H&S Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption.
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The licensee's stated that they understand, that no person/s are allowed to be at the home, visiting or living there, during day care hours, until they are fingerprint cleared and associated to their day care license, or have an exemption.
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This requirement was not met as evidenced by information obtained through interviews conducted. Therefore, a $500.00 civil penalty is assessed ($100.00 per violation per day for a maximum of five days by the Department).
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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: 11/16/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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: 11/16/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/16/2020
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home. The licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement was not met as evidenced by the licensee's
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The licensee's agree to supervise children at all times in order to ensure their safety.
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admittance to a child in care being injured when he/she grabbed a hot cinnamon roll. This was due to the licensee not supervising at all times.
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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: 11/16/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3