393620128-9-13-2023-53-CC-BENN-CVPSXN-20230915141612

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393620128
Report Date: 09/13/2023
Date Signed: 09/13/2023 02:47:27 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2023 and conducted by Evaluator Stacey Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20230620093756

FACILITY NAME:	NEGRON, ASHLEY M		FACILITY NUMBER:	393620128
ADMINISTRATOR:	NEGRON, ASHLEY M		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 814-4222
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	14	CENSUS: 12	DATE:	09/13/2023
		UNANNOUNCED	TIME BEGAN:	01:06 PM
MET WITH:	Ashley Negron		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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weapons in the home

INVESTIGATION FINDINGS:

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On September 13, 2023, Licensing Program Analyst (LPA), Stacey Williams met with Licensee, Ashely Negron for the purpose of delivering complaint findings. LPA observed (12) twelve children supervised by Licensee and her Assistant.

An investigation was conducted regarding the allegation listed above. Interviews were conducted with the Reporting Party, the Licensee, Licensee’s Assistant, Licensee’s biological child, daycare childcare and parents of children attending the childcare. The Department of Social Services Investigation Branch (Investigator Bennett) assisted in the interview and home inspection process of the investigation. Licensee denied having a weapon in the facility. The facility was toured which included off limit areas of the home. There was no weapon found during the inspection. The Licensee acknowledged owning a weapon and reported the weapon is stored away from the facility. Although there was no evidence of a weapon in the facility during the inspection; a preponderance of evidence was not met to establish a weapon has never been in the home.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 53-CC-20230620093756

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: NEGRON, ASHLEY M	FACILITY NUMBER: 393620128
	VISIT DATE: 09/13/2023

NARRATIVE

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Inconsistent statements were received that did not corroborate the allegation. Based on the information received, the allegation is determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur.

No Title 22 deficiencies have been cited for this complaint.

An Exit Interview was conducted in which the report was reviewed and discussed with Licensee, Ashley Negron. Appeal rights provided. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

LIC9099 (FAS) - (06/04)

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