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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 394501211
Report Date: 11/13/2025
Date Signed: 11/13/2025 11:55:31 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2025 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20250916130553
FACILITY NAME:PETRY, QUIANA MICHELLEFACILITY NUMBER:
394501211
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Quiana M PetryTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Criminal Record Clearance-Provider has uncleared adult supervising children in care
INVESTIGATION FINDINGS:
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On 11/13/25, Licensing Program Analysts (LPAs) Elvira Sierra and Stacey williams met with Licensee, Quiana M Petry to conduct an unannounced complaint inspection to deliver finding for the above complaint allegation. During today’s inspection there were five children present being supervised by Licensee and Licensee's assistant.

It was alleged that the Provider has uncleared adult supervising children in care. Throughout the investigation, LPA interviewed the Reporting Party (RP), current and previous parents, licensee’s assistant, and licensee. During the investigation, LPA learned that adult # 1 is present and assisting with the daycare children prior to having her fingerprints associated with the facility. The Department received association of fingerprint clearance for adult # 1 on 09/19/25. Also, interviews conducted revealed that Adult #2 frequent the home and assist with daycare children and the Department have no fingerprint clearance on file.

Report continues on subsuquent page 809C--
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 53-CC-20250916130553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PETRY, QUIANA MICHELLE
FACILITY NUMBER: 394501211
VISIT DATE: 11/13/2025
NARRATIVE
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Based on interviews conducted and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. See attached LIC 9099D page for deficiencies cited today. Civil penalties are being accessed. License received and understood appeal rights.

An exit interview was conducted in which the report was reviewed and discussed with license and Notice of Site Visit was posted. LPA Sierra informed licensee, Quiana M Petry that this report dated 11/13/25 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Sierra informed the licensee to provide a copy of this licensing report dated 11/13/25 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2025 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20250916130553

FACILITY NAME:PETRY, QUIANA MICHELLEFACILITY NUMBER:
394501211
ADMINISTRATOR:PETRY, QUIANA MICHELLEFACILITY TYPE:
810
ADDRESS:3406 CHARLESTON CTTELEPHONE:
(209) 237-7654
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:11CENSUS: 5DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Quiana M PetryTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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License-Licensee is not present at least 80% of day care hours
INVESTIGATION FINDINGS:
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On 11/13/25, Licensing Program Analysts (LPAs) Elvira Sierra and Stacey Williams conducted a complaint investigation and met with Licensee, Quiana M Petry to deliver findings on the above allegation. Present in the home were Licensee and Licensee’s assistant caring for five children.
Reporting party (RP) alleged that Licensee is not present at least 80% of daycare hours. Throughout the investigation LPA conducted interviews with RP, Licensee, staff, and daycare parents. LPA also observed the care and supervision of children. During interviews LPA received inconsistent information regarding whether Licensee is present at least 80% of daycare hours due to facility operating hours, which consist of 7 days a week, 24 hours a day. Licensee stated that she does provide transportation for clients and she is in and out of the home at diffenerent times of the day.
Based on the information obtained during interviews there is not a preponderance of evidence to prove the allegation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

Report continues on subsuquent page 809C--

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 53-CC-20250916130553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PETRY, QUIANA MICHELLE
FACILITY NUMBER: 394501211
VISIT DATE: 11/13/2025
NARRATIVE
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An exit interview was conducted in which the report was reviewed and discussed with Licensee, Quiana M Petry. Appeals of rights were provided to Licensee and a Notice of site visit was posted and shall remain posted for 30 days.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20250916130553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PETRY, QUIANA MICHELLE
FACILITY NUMBER: 394501211
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/14/2025
Section Cited
CCR
102370(d)(1)(2)
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102370 Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or (2) Request a transfer of a criminal record clearance as specified in Section 102370(j) .

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POC: Licensee stated that Adult #1 is associated to the facility since 09/19/25 and that she will Appeal for Adult #2 becasue she has never help with the daycare children.
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This requirement was not met as evidence by;
Adult #1 was working at the facility prior to have her criminal record clearance associated to the facility. Also Adult # 2 help with daycare children at least once and have no record criminal clearance on file with the Department. This is a requirement that if not corrected poses an immediate risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5