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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500873
Report Date: 03/12/2025
Date Signed: 03/12/2025 11:51:11 AM

Document Has Been Signed on 03/12/2025 11:51 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:FERREYRA, VERONICAFACILITY NUMBER:
394500873
ADMINISTRATOR/
DIRECTOR:		VERONICA FERREYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 470-1450
CITY:LODISTATE: CAZIP CODE:
95242
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
03/12/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Veronica FerreyraTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Erwin Tjhia conducted an unannounced Case Management inspection to verify the removal of Jose Cuevas from the facility. Present in the facility were 5 children supervised by 1 staff.

LPA inspected the entire home inside and out. Licensee, Veronica Ferreyra, stated that she understands this person is not permitted to be in the home or on the premises at any time when children are in care.

Based on evidence obtained during today's inspection, LPA have verified the individual is not present, employed or residing at the facility.

*No deficiencies cited today under Title 22 Division 12 of the Ca. Code of Regulations*.

This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit was observed being posted.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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