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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621715
Report Date: 07/28/2023
Date Signed: 08/22/2023 02:45:54 PM

Document Has Been Signed on 08/22/2023 02:45 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:FIELDS, TARRAFACILITY NUMBER:
343621715
ADMINISTRATOR:TARRA FIELDSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 260-7014
CITY:SACRAMENTOSTATE: CAZIP CODE:
95842
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Tarra FieldsTIME COMPLETED:
01:15 PM
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This is an amended report.

On July 28, 2023, Licensing Program Analysts (LPAs) Amanda Sutter and Kyrsten Willams met with Licensee Tarra Field for a case management inspection to discuss the unusual incident report (UIR) that was reported and submitted on July 10, 2023. Upon arrival, LPAs observed 7 children.

LPAs took photos of the home and were provided documents. No deficiencies were cited in today’s visit.

Exit interview was conducted with Licensee Tarra Fields and notice of site visit was posted.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2023
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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