<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500873
Report Date: 02/14/2025
Date Signed: 02/14/2025 12:52:52 PM

Document Has Been Signed on 02/14/2025 12:52 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:FERREYRA, VERONICAFACILITY NUMBER:
394500873
ADMINISTRATOR/
DIRECTOR:		VERONICA FERREYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 507-5088
CITY:LODISTATE: CAZIP CODE:
95242
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
02/14/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Veronica FerreyraTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Erwin Tjhia met with licensee, Veronica Ferreyra for an unannounced Case Management inspection. Present in the facility were 1 staff caring for 3 children during today inspection.

The purpose of the inspection was to follow up on an unusual incident that occurred on 11/24/2024; which was self reported to the Department by the facility. Throughout the investigation, LPA conducted interviews, and obtained pertinent information.

LPA learned that children were engaged in inappropriate play. Interview with licensee, children, and parents revealed that there was no adult staff supervising the children which resulted in the conduct between the two children. Licensee was in the kitchen not aware of the incident until she was informed by another child.

Licensee did not maintain care and supervision of children resulting in Child #1 inappropriately interacting with Child #2. Therefore, a Type A deficiency is cited on the subsequent page 809-D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files.



An Exit Interview was conducted in which the report was reviewed and discussed with licensee, Veronica Ferreyra. A copy of the report and Appeal Rights were provided to Licensee and a Notice of Site Visit was posted by the LPA.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2025
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 2
Document Has Been Signed on 02/14/2025 12:52 PM - It Cannot Be Edited


Created By: Erwin Tjhia On 02/14/2025 at 11:03 AM
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: FERREYRA, VERONICA
FACILITY NUMBER: 394500873

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/15/2025
Section Cited
CCR
102417(a)

1
2
3
4
5
6
7
102417 Operation of a Family Child Care (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
1
2
3
4
5
6
7
Licensee disenrolled the child #1 that initiated the inappropriate play. Licensee and staff shall complete training on supervising children in care by watching Child Care Licensing Videos on active supervision https://CCLD.CHILDCAREVIDEOS.ORG and submit a written statement on how facility staff will ensure active supervision of children in care by POC due.
8
9
10
11
12
13
14
Based on interviews and record reviews, the licensee did not adequately supervise day care children which resulted in inappropriate play between two children while in care which poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karyn Guerra
LICENSING EVALUATOR NAME:Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2025


LIC809 (FAS) - (06/04)
Page: 2 of 2