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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 550318064
Report Date: 10/03/2024
Date Signed: 10/03/2024 12:23:31 PM

Document Has Been Signed on 10/03/2024 12:23 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:BELLEVIEW SCHOOLFACILITY NUMBER:
550318064
ADMINISTRATOR/
DIRECTOR:		KIMBERLY ANGELFACILITY TYPE:
850
ADDRESS:22736 KEWIN MILL ROADTELEPHONE:
(209) 586-5510
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY: 24TOTAL ENROLLED CHILDREN: 6CENSUS: 1DATE:
10/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Carmel Portillo, Superintendant-PrincipalTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 10/03/2024 at 11:30am Licensing Program Analyst (LPA) Tobias Lake met with Carmel Portillo, Superintendant-Principal, for a Case Management Inspection to verify corrections of violations cited at the last inspection. Today’s census was one child. On 8/29/2024, a Type A deficiency was cited for criminal record clearance when an individual who did not have clearance with the Department or the California Teacher Commission was present and providing care at the facility.

LPA toured the preschool classroom, observed the care and supervision of the present child by the new Site Supervisor, and reviewed records. All staff present today have clearance through the school district. Carmel Portillo stated that the uncleared individual has not returned the preschool classroom and will not be present in the preschool classroom until clearance is obtained and verified. Children’s files contained signed Acknowledgements of Receipt of Licensing Report Forms (LIC 9224). The deficiency cited on 8/29/2024 is cleared with today’s inspection. A Proof of Correction Letter was provided.

An Exit Interview was conducted, and a Notice of Site Visit was posted.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Tobias Lake
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2024
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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