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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409269
Report Date: 06/26/2024
Date Signed: 06/26/2024 03:33:09 PM

Document Has Been Signed on 06/26/2024 03:33 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:BELLOT, JANEENEFACILITY NUMBER:
073409269
ADMINISTRATOR/
DIRECTOR:		BELLOT, JANEENEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 726-6853
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
06/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Janeene BellotTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 06/26/2024 at 2:15 PM, Licensing Program Analysts (LPAs) Christina Watts and Karecca Sykes conducted a Case Management inspection at Janeene Bellot's large family child care home. LPAs met with licensee Janeene Bellot and explained the purpose of today's inspection. During today's inspection, there were 14 children in care (10 preschool children, 3 school age children and 1 infant child) and 16 children enrolled. Also present during inspection were 2 assistants and licensee's grandchild. All adults present, caring and supervising children have Criminal Record Clearance.

LPA is following up on citation facility received on 05/02/2024. Licensee was cited for Alterations to a Family Child Care Home and Child's records. LPA reviewed licensee's paperwork and licensee has Identification and Emergency Information for Family Child Care Home (LIC 700), Family Child Care Home Notification of Parent's Rights (LIC 995A), Consent for Emergency Medical Treatment for Family Child Care Home (LIC 627), among other forms required for a family child care home. LPAs also observed parent/authorized representative signaturez on required forms. Licensee stated that Fire Department will conducted Fire Safety Clearance on Monday, July 1, 2024 at 8:30 AM. LPAs informed licensee that garage cannot be used for care and supervision until Fire Clearance has been approved and licensing has conducted inspection to place garage on limits.

As of 06/26/2024, the Plan of Corrections has been CLEARED and clearance letter has been provided to licensee.

During today's inspection, there were no violations observed.

Exit interview conducted and report was reviewed with the licensee, Janeene Bellot. A notice of site visit was given and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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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