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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625564
Report Date: 08/07/2024
Date Signed: 08/07/2024 01:57:21 PM

Document Has Been Signed on 08/07/2024 01:57 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:SIMS, TAZJINAEFACILITY NUMBER:
343625564
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
08/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Tazjinae SimsTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 12:45pm and met with licensee, Tazjinae Sims for the purpose of a change of capacity inspection. Also present was licensee’s fiancé and minor child. Today’s census was one child. All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety inspection were conducted inside and out. Off-limits areas: Garage, all bedrooms except daughter’s room. LPA observed at time of inspection the facility was incompliance with Title 22 regulations and the Health and Safety Code.


Effective today 8/7/24, Licensed for large family child care home.
Facility is approved for a Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Without assistant, the ratios revert to those for small family childcare home. Exit interview conducted and report was reviewed with the [applicant, licensee, or facility representative] Tazjinae Sims.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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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