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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500666
Report Date: 10/14/2025
Date Signed: 10/14/2025 11:52:56 AM

Document Has Been Signed on 10/14/2025 11:52 AM - 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/
DIRECTOR:		DENYSE GONZALES-GRAYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 981-5736
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/14/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Gonzales-Gray, DeniseTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On October 14th, 2025, at 9:30 AM, Licensing Program Analysts (LPAs) David Nguyen and Deborah Khashe met with licensee Denyse Gonzales-Gray to conduct a proof-of-correction inspection to verify the corrections of two (2) Type-A deficiencies cited on October 8th, 2025. The purpose of the proof-of-correction inspection was explained. There were nine (9) children present during today’s proof-of-correction inspection. Licensee’s assistant was also present at the start of the inspection.

On October 8th, 2025, the facility was cited for one (1) Type-A deficiency for not complying with the pool safety measures for a Family Child Care Home with an in-ground swimming pool on the premises. During the inspection on October 8th, 2025, licensee did not have a body hook attached to a fixed 12-foot pole, daily pool safety checklists, a working self-closing and self-latching gate, an US Coast Guard approved ring with a minimum 17 inches, and an ASTM standard pool alarm.

During today's inspection, LPAs toured on-limits areas. LPAs reviewed children’s records and observed the Acknowledgment of Receipt of Licensing Report—LIC9224, signed by parents in children’s files. In addition, LPAs inspected the pool area, and LPAs observed the pool mesh fence has multiple tears and holes. LPAs discussed with licensee that the pool mesh fence need to be maintained and be in good repair at all times. Licensee acknowledged that she needs to repair the mesh fence for her in-ground swimming pool within 30 calendar days and maintain her mesh pool fence in good repair at all time.

Report continues on LIC809-C... (Page 2)

NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: David Nguyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2025
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 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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, DENYSE
FACILITY NUMBER: 394500666
VISIT DATE: 10/14/2025
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(Page 2)
Furthermore, LPAs observed a body hook attached to a fixed 12-feet pole, an ASTM standard pool alarm but not ready for use, and daily pool safety checklist. However, LPAs did not observe a working self-closed and self-latched gate and the U.S Coast Guard Approved ring with a minimum 17-inch. During today’s visit, licensee stated that she has ordered the ring online. In addition, licensee stated that her pool gate has not been fixed yet because it needs the adjustments on the spring, and it is in process of being repaired. Licensee stated that she will get her ASTM standard pool alarm ready for use by charging it, setting it up, placing in in pool water, and testing it. Licensee stated that she still wanted to make the backyard off-limits until all the corrections have been made. The Type-A deficiency cited on October 8th, 2025, for not complying with pool safety measures for a Family Child Care Home with an in-ground swimming pool on the premises was not cleared with today’s visit.

In addition, on October 8th, 2025, the facility was cited for one (1) Type-A deficiency for not physically checking on the infants every 15 minutes while they are sleeping and documenting the 15-minute checks on the infant napping logs. During today’s inspection, LPAs reviewed the 15-minute infant sleep logs on licensee’s cell phone. The Type-A deficiency cited on October 8th, 2025, for not checking on the infants every 15 minutes while they are sleeping and documenting the 15-minute checks on the infant napping logs was also cleared with today’s visit.

The Type-A deficiency cited on 10/8/2025, for not complying with the pool safety measures for a Family Child Care Homes with an in-ground swimming pool on the premises was not cleared during today’s visit. During today’s inspection, LPAs did not observe a working self-closed and self-latched gate. Civil penalties were assessed for failure to correct this deficiency.

An exit interview was conducted with licensee, Gonzales-Gray, Denyse. Appeal rights and a Notice of Site Visit were provided. Licensee’s signature on this form acknowledged the receipt of the form. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: David Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2025
LIC809 (FAS) - (06/04)
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