<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622222
Report Date: 09/10/2021
Date Signed: 09/10/2021 09:50:14 AM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:GONZALES-GRAY, DENYSEFACILITY NUMBER:
393622222
ADMINISTRATOR:GONZALES-GRAY, DENYSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 478-7399
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY:14CENSUS: 8DATE:
09/10/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Denyse Gray-GonzalesTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
At 08:45 AM Licensing Program Analyst (LPA) Elvira Sierra conducted an unannounced case management inspection and met with Licensee, Denyse Gray-Gonzales for the purpose of adding a room to the daycare areas. Facility operates from 07:30 AM to 05:00 PM Monday- Friday. Upon arrival present in the facility was Licensee and her daughter caring for 7 children. One more child arrived during the inspection.

At 09:00 AM a health and safety inspection was conducted in all areas accessible to children. LPA observed sufficient amount of toys, and play equipment in the home. LPA observed a functional carbon monoxide detector and smoke detector and a fully charge fire extinguisher that meets regulations. LPA inspect the room that Licensee is requesting to add to the daycare and the following was observed; play equipment is appropriate for the children in care, toys and reading material was observed. Licensee stated room will be used as play area. Room is located on the back of the garage. Licensee stated garage will be used only to enter the room.

Room will be added to the daycare areas upon Management approval.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1