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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844404
Report Date: 05/21/2019
Date Signed: 05/21/2019 02:54:56 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:ROSEBOROUGH FAMILY CHILD CAREFACILITY NUMBER:
364844404
ADMINISTRATOR:ROSEBOROUGH, TERRYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 677-3284
CITY:RIALTOSTATE: CAZIP CODE:
92377
CAPACITY:14CENSUS: 2DATE:
05/21/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Terry Roseborough, LicenseeTIME COMPLETED:
03:25 PM
NARRATIVE
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On date and time listed, Licensing Program Analyst's (LPA's), Taadhimeka Ziegler and Carlos Martinez, arrived at the facility to conduct an Annual/Random inspection. LPA toured the facility, inside and out, records were reviewed and the following was observed and/or discussed:

Normal days and hours of operation are: Monday- Sunday, 5:30 a.m.- 8:00 p.m.
OFF-LIMIT AREAS INCLUDE: 2nd Floor, Downstairs Bedroom, Backyard, laundry room, and garage area.
· The facility is operating within the licensed capacity and appropriate ratios
· The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children
· A working telephone is present
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector is present and were tested by the applicant during this inspection.
· All hazardous items are inaccessible, this includes: detergents, cleaning compounds, medications and other items which could pose a danger to children
· Storage of poisons is inaccessible to children and locked in the garage.
· There is a fireplace that is barricaded.
· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 regulations.
· The stairs were barricaded.
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
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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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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
VISIT DATE: 05/21/2019
NARRATIVE
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A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY 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).

A Confidential Names List was completed and provided to the LICENSEE.

A copy of this report was provided to the licensee on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 7 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
VISIT DATE: 05/21/2019
NARRATIVE
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- Verification of control of property on file
- Property owner/landlord notification and consent on file
- Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
- There was no documentation for Disaster Drills on file.
- Pediatric CPR and First Aid Card expires on 03/19/22.
- There is no body of water on premises. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
- Clean, safe and age appropriate toys.
- Each child’s file contains a copy of the emergency information card with required information.
- The licensee was asked to provide information in regard to having an association to any licensed community care facility.

- Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. This was verified on 05/21/19.
- The Department was granted inspection authority as required by the Health and Safety Code


· Facility is not currently providing IMS at this time. 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
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 2 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2019
Section Cited
HSC
1596.7992
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HEALTH & SAFETY:

SB 792– A person may not be employed or volunteer at a child care center or a family child care home unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption. This poses a potential risk to the Health and Safety
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The Licensee agreed to submit immunizations in accordance with SB792, to the CCL by POC due date.
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of children in care due to staff not being immunized against influenza, pertussis, measles and/or by not having a medical exemption. This requirement was not met as evidenced by; LPA noted that the Licensee did not have proof of Immunization Records on file.
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Type B
06/21/2019
Section Cited
CCR
102417(g)(9)(A)(1)
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OPERATION OF A CHILD CARE HOME:

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. This requirement was not met as evidenced by; LPA noted that there were no records of Disaster Drills on file.
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Licensee agrees to conduct a fire/disaster drill, log it, and submit a copy of the log to the Riverside Child Care Regional Office by POC due date.
Type B
06/21/2019
Section Cited
CCR
102417(g)
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OPERATION OF A CHILD CARE HOME:

The home shall be free from defects or conditions which might endanger a child. This requirement was not met as evidenced by; LPA observed that some electrical outlets were missing a cover/protective cap.
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Licensee agreed to cover all electrical outlets with a protective cap by POC due date.
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: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 8 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
VISIT DATE: 05/21/2019
NARRATIVE
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- AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015 – In accordance with California Health and Safety Code Section 1975.543 - Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections

- AB 2236 – Civil Penalties, effective July 1, 2015 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury, or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund in order to assist parents in securing alternative child care when a Child Care Center or Family Child Care Home license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all of the licensee’s facilities and not just the specific facility cited or limited to that facility type.

- SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.

- AB 290 – Child Nutrition, effective January 1, 2016 - – In accordance with California Health and Safety Code Section 1596.866 - each family day care home licensee who provides care, shall have at least one hour of childhood nutrition training as part of the preventive health practices course or courses.

- SB 792 – Immunization requirements for staff, volunteers, effective September 1, 2016 –
(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 4 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
VISIT DATE: 05/21/2019
NARRATIVE
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- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.

- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov.
- Please subscribe at www.childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).


See LIC809D for cited deficiencies.
Appeal rights discussed and a copy of this report was provided to the licensee on this date.


During the exit interview, the LICENSEE, Terry Roseborough, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 6 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2019
Section Cited
CCR
102417(g)(4)
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OPERATION OF A CHILD CARE HOME:

The home shall be free from defects or conditions which might endanger a child. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are
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Deficiency cleared. Licensee removed all items and placed them in the laundry room inaccessible to children.
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inaccessible to children. This requirement was not met as evidenced by; LPA Martinez observed several toxins (Fabuloso, 16 Fl oz, Murphy-Oil Soap, 16 Fl oz, and Orange-Glo, 16 Fl oz) in an unlocked kitchen cabinet accessible to children.
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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: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 9 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
VISIT DATE: 05/21/2019
NARRATIVE
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· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

The following was reviewed with the licensee(s):

- AB 2084 - Nutritious Beverages in Child Care Facilities effective January 1, 2012 - was explained that only low-fat or non-fat milk is to be served to children 2 years of age or older; and limit juice to one serving of 100% juice per day; serve no beverages with added sweeteners; and water must be available and accessible to children throughout the day.

- AB 1819 – Smoking prohibition on the premises of Family Child Care Homes, effective January 1, 2015 – This bans smoking tobacco in a home that is licensed as a family child care home, and in those areas of the family child care home where children are present. This change in law was based on demonstrated negative health effects of second and “third hand” smoke on children. Third hand smoke generally refers to the residue from tobacco smoke that sticks to surfaces after the secondhand smoke has cleared.

- AB 2621 – Public information posted on the internet, effective January 1, 2015 – The Department shall post licensing reports for Family Child Care Homes on its Internet Web site. This information will be updated at least monthly on the website and will span the preceding five-year period.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 3 of 9
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: ROSEBOROUGH FAMILY CHILD CARE
FACILITY NUMBER: 364844404
VISIT DATE: 05/21/2019
NARRATIVE
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- AB 2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For a Zero Tolerance violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Zero Tolerance violation the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.


- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills are to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The licensee is urged to visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Carlos MartinezTELEPHONE: (951) 782-4936
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 5 of 9