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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624490
Report Date: 07/07/2023
Date Signed: 07/07/2023 08:54:32 AM

Document Has Been Signed on 07/07/2023 08:54 AM - 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:SHINE, TAMARAFACILITY NUMBER:
343624490
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/07/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Tamara Shine- ApplicanrTIME COMPLETED:
09:00 AM
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An announced second pre-licensing inspection is conducted today by Licensing Program Analyst Owens and Vang. LPA's met with Applicant, Tamara Shine.

The purpose of the inspection is to observe a mesh fencing that has been installed to separate windows facing the pool. LPA's observe a mesh pool fencing that has been installed and separates the windows facing the pool; the fencing makes the pool inaccessible to the windows. Applicant is made aware that the mesh pool fencing that separates the windows from the pool has to be in place at all time when day care children are present. The pool fencing around the pool meets Title 22, Division 12, Chapter 3 Regulations with a self closing, self latching gate that swings away from the pool .

Effective today 7/7/2023, applicant is license to serve up to either 8 children, two (2) of which must be at least 6 years of age and no more than two (2) may be infants; or 6 children, three (3) of which may be infants; or 4 infants only. Infants are children under the age of 2 years.

Exit Interview were conducted.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023
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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