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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334815209
Report Date: 07/30/2025
Date Signed: 07/30/2025 01:02:40 PM

Document Has Been Signed on 07/30/2025 01:02 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ROTH FAMILY CHILD CAREFACILITY NUMBER:
334815209
ADMINISTRATOR/
DIRECTOR:
ROTH, MINDYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 719-1134
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY: 14TOTAL ENROLLED CHILDREN: 35CENSUS: 0DATE:
07/30/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Mindy RothTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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Licensing Program Analyst (LPA) William Chancellor conducted an unannounced annual inspection for Roth Family Childcare (FCCH) on July 30, 2025, at 10:29 AM. LPA was greeted Derrick Roth and met with Licensee (LIC) Mindy Roth, who granted entry and provided LPA a tour through the FCCH.

The facility operates Monday through Friday from 8:30 AM- 3:00 PM, serving children from two and a half to six years old. Certain areas listed as off-limits include entire upstairs, office, kitchen, living room, attached garage and backyard with swimming pool. Children primarily utilize the front daycare rooms, side patio and fenced backyard with play structure and playhouse. Off-limit areas include locks, and child safety gates making them inaccessible to children. Facility is licensed as a large FCCH with a maximum capacity of fourteen (14) children and is operating within the capacity listed on the license. Due to summer vacation, no children were present during the inspection.

A working cell phone is available, and the current phone number on file is correct. A fully charged fire extinguisher (2A:10BC) was observed near the daycare room outside of the restroom. LPA observed smoke detectors mounted in the daycare hallway. Kitchen knives were observed to be inaccessible to daycare children in a raised kitchen cabinet. LPA reminded licensee that all poisons and cleaning compounds deemed hazardous must be locked by a key. The license stated they understand that all off-limit areas are made inaccessible by child safety gates, doorknobs or lock and key, and must be operational during daycare hours.

A current roster was requested and available for review during inspection. LPA confirmed the required postings, including the Facility Sketch, Emergency Disaster Plan, License and Notification of Parent’s Rights, are displayed in the daycare entry way. Fire and disaster drill documentation was available, recording the last drill in June 2025. Licensee was reminded that drills are required at least every six months, documenting fire and earthquake drills on different dates.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ROTH FAMILY CHILD CARE
FACILITY NUMBER: 334815209
VISIT DATE: 07/30/2025
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Licensee stated they understand that all firearms, weapons, and ammunition must be locked separately and made inaccessible as per Title 22 Regulations. .

LPA confirmed an in ground swimming pool and spa in the backyard of the home. The pool is made inaccessible to daycare children by a 5.5-foot vinyl fence, that is attached to the home and playhouse. The vinyl fence is comprised of vertical beams that do not obstruct the view of the swimming pool. LPA observed a latch with a numerical dialed code, utilized to lock the vinyl white gate. LPA confirmed the bottom of the vinyl fencing is flush with the ground and no spacing exceeds more than two inches. There are no gaps or openings large enough to allow the passage of a sphere with a diameter of four inches or more. The fence has no protrusions, cavities, or other features that could serve as handholds or footholds for climbing. The gate was verified to open away from the pool and is self-closing and self-latching. The latch is equipped with a key-lockable device located at least 60 inches above ground level.

Additionally, there is an mesh fencing installed from the white vinyl fence to the neighbors’ exterior fencing. The mesh fencing is 5 foot in height and reaches across the entire length of the covered patio, making the swimming pool inaccessible from the homes exterior windows and French doors. LPA confirmed the bottom of the mesh fencing is flush with the ground and no spacing exceeds more than two inches. There are no gaps or openings large enough to allow the passage of a sphere with a diameter of four inches or more. The fence has no protrusions, cavities, or other features that could serve as handholds or footholds for climbing. The gate was verified to open away from the pool and is self-closing and self-latching. The latch is equipped with a key-lockable device located at least 60 inches above ground level.

LPA observed two pool alarms placed in the in-ground swimming pool and spa. LPA and licensee confirmed both to be operating when movement of the water was tested. Documentation confirming compliance with ASTM International Standard F2208. Additionally, LPA confirmed the presence of required safety equipment: a life ring with a minimum exterior diameter of 24 inches, labeled as U.S. Coast Guard approved and a 12-foot fixed length rescue pole with a body hook. All safety equipment was visible and readily accessible from the pool area. The licensee maintains a daily pool inspection log to ensure all safety measures are in place prior to opening the facility.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ROTH FAMILY CHILD CARE
FACILITY NUMBER: 334815209
VISIT DATE: 07/30/2025
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Present in the backyard is a child playhouse. The playhouse is within the mesh fencing, approximately fifteen feet from the swimming pool. The playhouse has three openings, two with aluminum bars and one plexiglass viewpoint. The aluminum bars are reinforced within the playhouse walls and do not exceed a four inch opening. The plexiglass viewpoint does not operate as a window and does not open or slide. Each are permanent enclosings and neither provide access to the swimming pool.

As of this date of this inspection, the fencing does meet Title 22 Regulations. Children do not have access to the swimming pool or spa through the child play house or homes exterior windows or French doors leading from the kitchen.

Both children and employee records were audited during this inspection. Mandated Reporter Training is on file and current for licensee, expiring in August 2026. Licensee Pediatric CPR and First Aid certification is current, expiring in July 2026. Resident and staff records were reviewed, and all adults requiring caregiver background checks have received the necessary clearances and exemptions.

Licensee Mindy Roth was reminded that all adults 18 and over, living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ROTH FAMILY CHILD CARE
FACILITY NUMBER: 334815209
VISIT DATE: 07/30/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200. Unusual Incident Reports (UIR) must be called in within 24 hours and then electronically emailed or faxed within 7 business days at: unusualincidentreportsDO10@dss.ca.gov. Please refer to Title 22: 102416.2 Reporting Requirements- to reference mandatory reasons or incidents required to be self-reported to (CCL) in a timely manner.



On July 1, 2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ROTH FAMILY CHILD CARE
FACILITY NUMBER: 334815209
VISIT DATE: 07/30/2025
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process for CARE tools, please send the email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

There are no deficiencies being cited at this time.

A Notice of Site Visit (NOS) was provided and must remain posted for 30 consecutive days. LPA reminded licensee, Mindy Roth, that the NOS must be posted in a prominent space available to parents, guardians or care givers.

An exit interview was conducted with Licensee, Mindy Roth. A copy of this report, along with appeal rights were discussed and provided during the exit interview.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
LIC809 (FAS) - (06/04)
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