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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621715
Report Date: 08/22/2023
Date Signed: 08/22/2023 02:46:21 PM

Document Has Been Signed on 08/22/2023 02:46 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: 5DATE:
08/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Tarra FieldsTIME COMPLETED:
03:00 PM
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On August 22, 2023, Licensing Program Analyst (LPA) Amanda Sutter met with Licensee Tarra Field for a case management inspection to obtain signatures and deliver an amended report. Upon arrival, LPA observed 5 children.

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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