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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191602514
Report Date: 06/18/2025
Date Signed: 06/18/2025 02:46:57 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2025 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20250429083956
FACILITY NAME:DER KINDER GARDEN INFANT CENTERFACILITY NUMBER:
191602514
ADMINISTRATOR:JAYASURIYA, TARISHAFACILITY TYPE:
830
ADDRESS:1843 10TH ST.TELEPHONE:
(310) 318-3838
CITY:MANHATTAN BEACHSTATE: CAZIP CODE:
90266
CAPACITY:30CENSUS: 16DATE:
06/18/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TARISHA JAYASURIYA, DIRECTORTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Allegation: : Personal Rights - Staff do not follow infant safe sleep practices.
INVESTIGATION FINDINGS:
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On 6/18/2025, Licensing Program Analyst (LPA) Loyce Phillips arrived at the facility to conduct an unannounced visit for the purpose of delivering the findings on the above allegation. Upon arrival LPA met with Director,Tarisha Jayasuriya and toured the facility. LPA observed 4 younger infants with 2 staff members in room #4 and 12 older infants with 3 staff members in room #5.

LPA conducted a full investigation, which included facility visits, documenting LPA observations, obtaining pertinent documentation, conducting file reviews, providing best practices and conducting interviews with staff and parents.

LPA conducted a visit on 4/30/2025 and observed 5 infants sleeping on their stomachs. LPA conducted a file review to verify all 5 infants had Individual Infant Sleeping plan-LIC 9227 on file. LPA observed LIC 9927 were completed and placed in the files. LPA conducted staff interviews. Staff 2 (S2) stated she placed child 1 (C1) on her stomach for a few seconds, to make sure she would go back to sleep. 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 30-CC-20250429083956
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DER KINDER GARDEN INFANT CENTER
FACILITY NUMBER: 191602514
VISIT DATE: 06/18/2025
NARRATIVE
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LPA conducted a file review for C1 that was placed on her stomach. LPA observed the LIC 9227 on file, but it wad not completed by parent. Therefore, the allegation that staff did not provide a safe sleeping environment for infants are deemed substantiated. A Substantiated finding means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency is cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety Codes.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, a deficiency is cited.


LPA, Loyce Phillips informed Director Tarisha Jayasuriya, that this report dated 6/18/2025 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA, Loyce Phillips informed the Director Tarisha Jayasuriya to provide a copy of this licensing report dated 6/18/2025 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will results in a civil penalty of 100.00.

An exit interview was conducted, and a copy of this report and appeals rights was provided to Director, Tarisha Jayasuriya.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 30-CC-20250429083956
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DER KINDER GARDEN INFANT CENTER
FACILITY NUMBER: 191602514
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/19/2025
Section Cited
CCR
101430(A)(1)
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101430 Infant Care Activities (A) Staff shall place infants up to 12 months of age on their backs for sleeping.(1)This requirement shall not apply if the infant has a written medical exemption from a licensed physician that allows for an alternative sleep position...This requirement was not met as evidence by:
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The Director will review Title 22 section 101430 and the Anatomy of Baby: Sleeping on Back vs, Stomach and provide a statement regarding your understanding of the material. Director will also train staff on safe sleep practices and send to LPA by POC date.
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During staff interviews, S2 stated she placed the infant on her stomach for a few minutes, to make sure the infant would go back to sleep. If not corrected, this poses an immediate risk to the health and safety of children in care.
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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.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2025 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20250429083956

FACILITY NAME:DER KINDER GARDEN INFANT CENTERFACILITY NUMBER:
191602514
ADMINISTRATOR:JAYASURIYA, TARISHAFACILITY TYPE:
830
ADDRESS:1843 10TH ST.TELEPHONE:
(310) 318-3838
CITY:MANHATTAN BEACHSTATE: CAZIP CODE:
90266
CAPACITY:30CENSUS: 16DATE:
06/18/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TARISHA JAYASURIYA, DIRECTORTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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2
3
4
5
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9
Allegation: : Personal Rights - Staff leave infants sleeping in swing while in care.
INVESTIGATION FINDINGS:
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On 6/18/2025, Licensing Program Analyst (LPA) Loyce Phillips arrived at the facility to conduct an unannounced visit for the purpose of delivering the findings on the above allegation. Upon arrival LPA met with Director,Tarisha Jayasuriya and toured the facility. LPA observed 4 younger infants with 2 staff members in room #4 and 12 older infants with 3 staff members in room #5.

LPA conducted a full investigation, which included facility visits, documenting LPA observations, obtaining pertinent documentation, conducting file reviews, providing best practices and conducting interviews with staff and parents.

LPA conducted a visit on 4/30/2025 and observed 5 infants sleeping on their stomachs. LPA conducted a file review to verify all 5 infants had Individual Infant Sleeping plan-LIC 9227 on file. LIC 9927 were completed and placed in the files. LPA conducted staff interviews, the staff that were interview stated infants do not sleep in swings. 1 staff stated that if an infant falls asleep in a swing, the infant is moved to the crib right away. 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 30-CC-20250429083956
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DER KINDER GARDEN INFANT CENTER
FACILITY NUMBER: 191602514
VISIT DATE: 06/18/2025
NARRATIVE
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 2 parents that were interviewed stated they were told by staff, their infants fall asleep in the swing. The parents stated they did not observe their infant or other infants sleeping in a swings. The other parents that were interviewed stated they have not observe infants sleeping in swings.

During visits to the facility LPA did not observe any infants sleeping in swings. Based on the evidence obtained, interview statements and observations; the allegation that staff leave infants sleeping in swings while in care is deemed Unsubstantiated.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur.

No deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety Codes.

An exit interview was conducted, a copy of this report, appeals rights and a notice of site visit were discussed and provided to Director, Tarisha Jayasuriya

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5