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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483002967
Report Date: 12/14/2023
Date Signed: 12/14/2023 10:06:11 AM

Document Has Been Signed on 12/14/2023 10:06 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:JONES, BETTYE FAMILY CHILD CARE HOMEFACILITY NUMBER:
483002967
ADMINISTRATOR:JONES, BETTYEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 310-0825
CITY:VALLEJOSTATE: CAZIP CODE:
94591
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
12/14/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Bettye Jones- LicenseeTIME COMPLETED:
10:30 AM
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On 12/14/23, Licensing Program Analyst (LPA), Cindy Castro made an unannounced POC visit and met with Licensee Bettye Jones (L1) for the purpose of following up on one Type B deficiency that was cited on 11/08/2023. L1 was cited on 11/08/2023 for the following:
1. If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

Upon arrival on 12/14/23 LPA observed six children being supervised. L1 stated that she currently only has 8 children enrolled in total.

There were no Title 22 deficiencies cited during today's inspection.

Exit interview conducted and report reviewed with Bettye Jones. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2023
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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