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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620128
Report Date: 01/10/2025
Date Signed: 01/10/2025 01:01:41 PM

Document Has Been Signed on 01/10/2025 01:01 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NEGRON, ASHLEY MFACILITY NUMBER:
393620128
ADMINISTRATOR/
DIRECTOR:		NEGRON, ASHLEY MFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 814-4222
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
01/10/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:17 PM
MET WITH:Ashley Negron TIME VISIT/
INSPECTION COMPLETED:
01:18 PM
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On January 10, 2025, Licensing Program Analyst (LPA) Stacey Williams met with Licensee, Ashley Negron for a plan of correction inspection. LPA observed eight children supervised by Licensee and her Assistant. Criminal record clearances were verified.

LPA reviewed facility files during today's inspection in conjunction with deficiencies cited on December 4, 2024.

Upon file review, it was revealed that all corrections have been made. Plan of Correction clearance letters were provided during today's inspection.

An Exit interview was conducted, and the report was reviewed with Licensee, Ashley Negron. LPA posted a notice of site visit. Licensee understands the Notice must remain posted for 30 days and that a failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights were provided. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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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