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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500666
Report Date: 10/08/2025
Date Signed: 10/08/2025 06:41:48 PM

Document Has Been Signed on 10/08/2025 06:41 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/
DIRECTOR:		DENYSE GONZALES-GRAYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 981-5736
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
10/08/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Gonzales-Gray, DenyseTIME VISIT/
INSPECTION COMPLETED:
07:00 PM
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On October 8th, 2025, at 2:30 PM, Licensing Program Analyst (LPA) David Nguyen met with licensee, Denyse Gonzales-Gray for the purpose of an unannounced annual inspection. The purpose of the unannounced annual inspection was explained. There were six (6) children present at the time of the inspection. Licensee’s operating hours are Monday through Friday from 7:30 AM. to 4:30 PM. Meals—breakfast, AM snack, lunch, and PM snack—were provided to daycare children. Drinking water was also provided for daycare children. LPA discussed with licensee the balance of the annual license fees, and LPA verified the annual license fees were up to date.

All adults subject to criminal background review have obtained criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

A health and safety inspection was conducted in all areas accessible to children. The detached one-story and single-family home consists of three (3) bedrooms, two (2) bathrooms, and an attached 2-car garage. The off-limits areas in the home include all the bedrooms, laundry room and the garage. The off-limit areas will remain inaccessible by door handle covers, closed locked doors, baby gate, and SUPERVISION. Licensee acknowledged that children are never allowed in the off-limit areas.

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: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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.

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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: 10/08/2025
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During today’s visit, licensee stated she wanted to make the backyard off-limits for the POC for the Type-A violation. The on-limits areas in the home include the living room, family room, kitchen, dining area, bathroom in the hallway. LPA observed the required postings and a working phone. 3A40BC fire extinguisher meets regulations. LPA observed smoke and carbon monoxide detectors, and verified they were both functional. LPA toured the kitchen area and verified knives were inaccessible to children in care. LPA observed living room area with age-appropriate toys for children. LPA observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. Licensee stated there are no weapons in the home. Outdoor play space is fenced.

There are bodies of water on the premises. The backyard has an in-ground pool that is fenced per Title 22 and HSC 1596.814 regulations. LPA also discussed with licensee and provided licensee a copy of HSC 1596.814 Swimming Pool Safety. LPA observed the gate NOT to self-close and self-latch. LPA did not observe a labeled United States Coast Guard life ring, a rescue pole with a body hook and minimum fixed length of 12 feet. LPA observed a pool alarm. However, the pool alarm is not a functioning ASTM International Standard F2208 pool alarm. LPA did not observe a daily inspection log of Licensee’s drowning prevention safety features and safety equipment. LPA discussed with licensee a daily inspection log of Licensee’s drowning prevention safety features and safety equipment.

Children's files were reviewed. Emergency information and required immunization records were on file. LPA observed a current roster and documentation that a fire drill is conducted at least once every six months. The last fire drill was conducted and logged on 9/26/2025. Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Current EMSA pediatric CPR and First Aid certification was verified and expires on 11/18/2025 and Child Care Provider Mandated Reporter certification was verified and expires on 10/18/2026.

Report continues on LIC809-C... (Page 3)
NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: David Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC809 (FAS) - (06/04)
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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: 10/08/2025
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA discussed with licensee the requirement to check and log infant napping every 15 minutes, for infants under 24 months. LPA provided licensee a copy of LIC 9227--Individual Infant Sleeping Plan, for infants under 12 months. LPA discussed with licensee the requirement to complete LIC9227—Individual Infant Sleeping Plan for infants under 12 months. During today’s visit, Licensee stated that she did not physically conduct the 15-minute checks. In addition, licensee stated she did not document the 15-minute checks on the 15-minute infant napping logs.

This provider is not currently providing Incidental Medical Services (IMS) services to children in care. IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PINs), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at
https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
Report continues on LIC809-C... (Page 4)
NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: David Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC809 (FAS) - (06/04)
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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: 10/08/2025
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, Denyse Gonzales-Gray confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for childcare updates, current forms, legislation, and regulation information.

Exit interview conducted and report was reviewed with the licensee, Denyse Gonzales-Gray. Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit was posted and must remain posted for 30 days.
Licensee's signature on this form acknowledges receipt of this form. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, two (2) type-A deficiencies were cited during today’s inspection.

LPA Nguyen informed licensee, Denyse Gonzales-Gray that this report dated (10/08/2025) documents two (2) Type A-citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.



Report continues on LIC809-C... (Page 5)
NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: David Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/08/2025 06:41 PM - It Cannot Be Edited


Created By: David Nguyen On 10/08/2025 at 06:03 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GONZALES-GRAY, DENYSE
FACILITY NUMBER: 394500666

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Request Denied
Type A
Section Cited
HSC
1596.814(a)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and nterview, licensee does not have a recuse body hook, daily pool safety checklists, a working self-close and self-latch gate, an ASTM standard pool alarm, and an US Coast Guard approved ring with a minimum 17 inches, and the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/09/2025
Plan of Correction
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Licensee agrees to obtain the required items as, such as a rescue body hook, US Coast Guard approved ring with a minimum 17 inches, pool alarm that meets ASTM standards, daily pool safety checklists, and a working self-close and self-latch gate by the POC due date (10/9/2025).
Type A
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, licensee does not physically checks the infants and document the 15-minute checks on the infant nappling logs, and the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/09/2025
Plan of Correction
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Licensee agrees to physically check the infants every 15 minutes while they nap, and licensee document the 15-minute checks on the infant napping logs. Licensee, in addition, agrees to submit the completed 15-minute infant napping logs to LPA by the POC due date (10/9/2025)
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Chayntel Hunter
NAME OF LICENSING PROGRAM MANAGER:
David Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/08/2025


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