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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804412
Report Date: 12/09/2020
Date Signed: 12/09/2020 02:28:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:COOLEY FAMILY CHILD CAREFACILITY NUMBER:
334804412
ADMINISTRATOR:COOLEY, BETTYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 785-8428
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY:14CENSUS: 11DATE:
12/09/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Betty CooleyTIME COMPLETED:
02:20 PM
NARRATIVE
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***Please note: Due to COVID-19, a tele-inspection is being conducted in lieu of an in-person/physical inspection***

On 12/9/2020 Licensing Program Analysts (LPAs) Samuel Lopez and Corey Hall contacted Licensee Betty Cooley, via FaceTime, to address and conclude an issue previously discussed with Betty, on 7/30/2020. This Case Management Tele-inspection is being conducted to address other issues that were gathered and discovered while addressing the previous and non-related issue.

LPA Lopez learned that a staff (Elizabeth Garbutt) had been working at the facility for almost a calendar year and was present during a tele-inspection on 7/30/2020, without being associated to the facility. The staff member did have a criminal record clearance and was associated to another facility, but the required documentation was never filed in order to transfer the staff’s criminal record clearance. Additional information obtained was that/regarding a two-year-old child being placed and/or allowed to sleep in an off-limits (Master) bedroom. Licensee Betty Cooley did not report the change to make the room available for use by the children in care. Also, there is an agreement by the Licensee and the Department, via a waiver, that states, “The door of the Master Bedroom must remain locked during the hours of operation”. The waiver was granted due to the presence of a pool, in the backyard, which is not fully surrounded/gated, as required by Title 22. Also, there is direct access to the pool from the Master Bedroom. On 12/9/2020, the licensee acknowledged that the child did sleep in the room.

The facility was found to be a violation of the following Title 22 regulations:

102416.3 Alterations to Existing Buildings or Grounds: (a)(6) Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

102416 Personnel Requirements: (d)(2) Prior to employment or initial presence in the childcare home, all employees and volunteers subject to a criminal record review shall request a transfer of a criminal record clearance as specified in Section 102370(j)

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: COOLEY FAMILY CHILD CARE
FACILITY NUMBER: 334804412
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/10/2020
Section Cited

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Personnel Requirements: Prior to employment or initial presence in the childcare home, all employees and volunteers subject to a criminal record review shall request a transfer of a criminal record clearance as specified in Section 102370(j).
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This requirement was not being met as evidenced by the licensee allowing an adult (Elizabeth Garbutt) to work without associating their criminal record clearance to her facility/license. This poses an immediate risk to the Health and Safety of the children in care. This citation is also subject to a civil penalty, which is being issued today.
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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.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: COOLEY FAMILY CHILD CARE
FACILITY NUMBER: 334804412
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2020
Section Cited

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Alterations to Existing Buildings or Grounds: Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care.
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This requirement was not being met as evidence by the information obtained that a two-year-old child was sleeping in an “off limits” bedroom. The licensee acknowledged that the child did sleep in the off limits bedroom. This poses a potential risk to the Health and Safety of the child(ren) in care.
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Also to include her understanding of the seriouness of the child sleeping in the "off limit" room with windows that have direct access to a pool. Statement/plan to be submitted by 12/16/2020.

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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.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: COOLEY FAMILY CHILD CARE
FACILITY NUMBER: 334804412
VISIT DATE: 12/09/2020
NARRATIVE
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See LIC 809-D for deficiencies

A Civil Penalty has been assessed during this Tele-inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC809D) CITED DURING THIS INSPECTION. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (WITHIN 24 HOURS OF THE CHILD’S NEXT DAY IN CARE) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS (AT THE TIME OF ENROLLMENT).

An exit interview was conducted, appeal rights were discussed, and a copy of this report was sent, via email, to the licensee (Betty Cooley) on this date.

***This report was sent via email on 12/9/2020. Betty has agreed to reply or to acknowledge that she has received it, via read receipt. This will serve as Betty's signature***

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4