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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610444
Report Date: 09/24/2026
Date Signed: 09/24/2026 12:02:09 PM

Document Has Been Signed on 09/24/2026 12:02 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:AMEZCUA, PATRICIAFACILITY NUMBER:
393610444
ADMINISTRATOR/
DIRECTOR:		AMEZCUA, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 951-0892
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 4DATE:
09/24/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Amezcua, PatriciaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On September 24th, 2026, at 9:00 AM, Licensing Program Analyst (LPA) David Nguyen met with the Licensee, Patricia Amezcua for the purpose of an unannounced annual inspection. The purpose of the unannounced annual inspection was explained to licensee. Upon arrival, LPA provided licensee with LIC126--Entrance Checklist for Family Child Care Homes. There were four (4) daycare children present at the time of the inspection. Licensee’s spouse/assistant was also present at the time of the inspection. Capacity specified on the license was met on today’s inspection. Facility days and hours of operation are Monday through Friday from 7:00 AM to 5:30 PM, year-round with periodic breaks throughout the year. LPA discussed with licensee that absences shall not exceed 20 percent of the hours that the facility is providing care per month. Licensee must notify the department in writing by the next business day anytime the facility is closed for vacation or any other leave that requires more than 20 percent of the day to be absent. Licensee was reminded to notify the department of any changes in her days and hours of operation. Meals—breakfast, AM snack, lunch, and PM snack—were provided to daycare children. Drinking water was also provided to daycare children with bottled water and filtered water. LPA discussed with licensee the balance of the annual license fees. LPA verified the annual license fees were up to date.

Report continues on LIC809-C... (Page 2)
Chayntel Hunter
David Nguyen
DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2026
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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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: AMEZCUA, PATRICIA
FACILITY NUMBER: 393610444
VISIT DATE: 09/24/2026
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A review of the Facility Personnel Summary shows that all adults living and working in the home have criminal record clearances on file with Licensing Office. The licensee stated that no new residents moved into the home during today’s visit.

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 family child care home is a detached one-story and single-family home and consists of three (3) bedrooms, two (2) bathrooms, and an attached one-and-half-car garage. The off-limits areas in the home include son’s bedroom, entire backyard, storage shed in backyard, and an attached one-and-half-car garage. The on-limits areas in the home include daycare room, dining room, office, dining area, kitchen, laundry room, bathroom in hallway,hallway, and bedroom # 1. The off-limits areas will be inaccessible to children by closed locked doors, baby gates, and SUPERVISION. Licensee stated that she understands children can never enter off-limits areas. Licensee was reminded to notify the department of any changes to her off-limits areas or vice versa.



LPA observed the posting of the facility license, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights in the playroom. Home is clean and appropriately ventilated. Facility maintains a working phone, 3A40BC fire extinguisher, and functioning smoke/carbon monoxide detectors. Age-appropriate toys and reading material were observed in the daycare areas. Per licensee, there are no weapons in the home. Toxic and hazardous items are inaccessible to children. There are no bodies of water on the premises. Outdoor area is fenced for supervision and was observed free of any hazards. During today’s visit, licensee stated that she utilizes the front yard for outdoor play. LPA reminded licensee that 100% SUPERVISION is always required for unfenced outdoor play area. Licensee acknowledged that she understands that 100% SUPERVISON is always required for outdoor play.
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: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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: AMEZCUA, PATRICIA
FACILITY NUMBER: 393610444
VISIT DATE: 09/24/2026
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Children’s files were reviewed. Emergency information and required immunization records were on files. LPA observed a current roster and documentation that a fire drill is conducted at least once every six months. Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Current pediatric CPR and First Aid certification was verified and expires on 02/08/2027, and Child Care Provider Mandated Reporter certification was verified and expired on 09/02/2025. LPA reminded licensee to renew the Pediatric CPR and First Aide and the Child Care Providers Mandated Reporter training every two (2) years.

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 and removing any 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.

During today’s visit, licensee stated that she is caring for infants. Licensee was made aware of the (LIC9227) Individual Infant Sleeping Plan, for infants under 12 months and sleep logs for all infants in care under 24 months need to be maintained in children’s files.

This provider is not currently providing IMS services to children in care. Incidental Medical Services (IMS) policy was discussed. During today’s visit, licensee acknowledges that a Plan for Providing IMS must be submitted to the Department if provided.
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: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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: AMEZCUA, PATRICIA
FACILITY NUMBER: 393610444
VISIT DATE: 09/24/2026
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Incidental Medical Services (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.

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 [email protected]. 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/process.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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



A notice of site visit was posted and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Patricia Amezcua.

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

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

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/24/2026 12:02 PM - It Cannot Be Edited


Created By: David Nguyen On 09/24/2026 at 11:17 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: AMEZCUA, PATRICIA
FACILITY NUMBER: 393610444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above by not having the 15-minute infant sleep logs for infants under 24 months which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/08/2026
Plan of Correction
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Licensee will submit proof of correction (infant sleep logs) to LPA by the POC due date (10/08/2026).
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above by not having a valid Child Care Providers Mandated Reporters Training in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/09/2026
Plan of Correction
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Licensee will obtain the Child Care Providers Mandated Reporters Training. Licensee will submit a certificate of completion for the Child Care Providers Mandated Reporters Training to LPA by the POC due date (11/09/2026)
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: 09/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/24/2026


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