197411105-4-10-2024-58-CC-ECAO-D482J9-20240410172558

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197411105
Report Date: 04/10/2024
Date Signed: 04/10/2024 05:26:08 PM

Document Has Been Signed on 04/10/2024 05:26 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	SENEVIRATNE FAMILY CHILD CARE		FACILITY NUMBER:	197411105
ADMINISTRATOR:	SENEVIRATNE, WASANTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 886-6828
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	14	CENSUS: 6	DATE:	04/10/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Wasantha Seneviratne, Licensee		TIME COMPLETED:	05:40 PM

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Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced annual required inspection to the above facility on 04/10/2024. LPA arrived at the facility at 2:00 PM, identified self and met with Wasanta Seneviratne, Licensee, who guided analyst on a tour of the inside and outside of the facility. There were 6 children present at arrival. Present were 1 Adult living in the home and 1 Staff (S1). LPA provided Licensee with a copy of the LIC125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 7:00AM to 6:00PM.

The licensee provided proof of control of property.

The family child care home is a one-story dwelling, includes living room, dining room, kitchen, 3 bathrooms, 3 bedrooms, play room, nap room and attached garage. LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed that play room, nap room, 1 bathroom (in the play room) are used for providing care and are accessible to children.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The children use the play room for child care activities and eating. There are tables and chairs, toys and play items that are safe, clean, and appropriate for the ages of the children. The napping room is used for sleeping. There are cots and bed linens available for children. The children use the bathroom in play room.

The kitchen is open to the dining area and cabinets are made inaccessible with the use of child proof locks. The licensee provides food for children in care. Licensee stated when food is brought to the facility it is labeled with child’s name and stored properly. There is telephone service via a landline that is used during operation hours.

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SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia Calvillo	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SENEVIRATNE FAMILY CHILD CARE	FACILITY NUMBER: 197411105
	VISIT DATE: 04/10/2024

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The outdoor play area is located in the back yard of the house, is fenced and there are no hazards to children present. LPA observed appropriate toys, swing, and other play equipment for children in care. LPA observed swing structure is secured to the ground and the ground is covered with fiber chips to absorb falls.

Per Licensee, areas off limits to children and parents include: 3 bedrooms, 2 bathroom and attached garage and made inaccessible by use of door lock to the entrance to the areas.

LPA did observe a front yard, per Licensee, the front yard is not used for child care activities. Children enter the home from a side gate by the play yard (near the play room).

Per Licensee, there are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no pets on the premises.

LPA did observe a fireplace that has been made inaccessible with the use of a metal screen attached to the wall and a lock.

There is a working fire extinguisher, smoke detector located in the living room and carbon monoxide detector located by the napping room and adequate heating and ventilation for safety and comfort.

There are currently no infants in care. 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.

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SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia Calvillo	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SENEVIRATNE FAMILY CHILD CARE	FACILITY NUMBER: 197411105
	VISIT DATE: 04/10/2024

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LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

Capacity as specified on the license is being maintained.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA reviewed a sample of children’s files and observed files were complete and documented on the LIC857.

An emergency fire/disaster drill has been completed and documented within the last 6 months on 03/04/2024. Licensee’s Mandated Reporter Training was completed on 05/11/2022. Licensee’s pediatric CPR/First Aid expires on 05/20/2025.

There were 1 personnel record for LPA to review and observed files were complete and documented on LIC859.

LPA reviewed with licensee the UC 311D, Forms/Records to Keep In Your Family Child Care Homes, children's forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia Calvillo	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SENEVIRATNE FAMILY CHILD CARE	FACILITY NUMBER: 197411105
	VISIT DATE: 04/10/2024

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All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care licensing/subscribe and select the Child Care option to receive email communication.

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SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia Calvillo	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SENEVIRATNE FAMILY CHILD CARE	FACILITY NUMBER: 197411105
	VISIT DATE: 04/10/2024

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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 or CARE tools, please send 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/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report and appeal rights were reviewed with Wasantha Senevirantne, Licensee.

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SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia Calvillo	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024

LIC809 (FAS) - (06/04)

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