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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500666
Report Date: 11/14/2023
Date Signed: 11/14/2023 01:14:53 PM

Document Has Been Signed on 11/14/2023 01:14 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:GONZALES-GRAY, DENYSEFACILITY NUMBER:
394500666
ADMINISTRATOR:DENYSE GONZALES-GRAYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 981-5736
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
11/14/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Denyse Gonzales-GrayTIME COMPLETED:
01:30 PM
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On November 14th, 2023, at 12:30 PM, Licensing Program Analyst (LPA), David Nguyen met with Licensee, Denyse Gonzales-Gray for an inspection of plan of correction. Purpose of the inspection was explained. During today's inspection, LPA inspected the on-limits areas.

On October 24th, 2023, the facility was cited a Type A deficiency due to Licensee did not adhere to not having proper pool fencing per Title 22. During today’s inspection visit, LPA observed the facility and the pool area and learned Licensee obtain proper pool fencing per the Title 22. The Type A deficiency that was cited on October 24th, 2023, is cleared by today's field visit. A Proof of Correction letter was provided to Licensee.

LPA discussed the Year-Round/Daily Reminder of Water Safety Requirements and Measures with licensee. LPA provided licensee the PIN 23-17-CCLD, the Year-Round and Daily Reminder of Water Safety Requirements and Measures. LPA reminded the licensee the importance of checking the pool gate and area daily to improve the children’s safety before the daycare children arrive and while the daycare children are playing outside and in her care.

In the areas that were evaluated, no deficiencies were cited. An exit interview was conducted, and the report was reviewed with Licensee, Denyse Gonzales-Gray. Licensee Appeal Rights were provided by LPA. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements will result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2023
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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