197415660-6-2-2023-12-CC-JTAO-CSESLA-20230602135800

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197415660
Report Date: 06/02/2023
Date Signed: 06/02/2023 01:58:05 PM

Document Has Been Signed on 06/02/2023 01:58 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	WEERASINGHE FAMILY CHILD CARE		FACILITY NUMBER:	197415660
ADMINISTRATOR:	WEERASINGHE, CHANDRIKA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 259-5498
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY:	14	CENSUS: 8	DATE:	06/02/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:44 AM
MET WITH:	Chandrika Weerasinghe, Licensee		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 06/02/23, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Chandrika Weerasinghe, who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story, 5 bedroom, 3.5 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is no pool/spa or body of water on the premises. Upon arrival LPA observed 3 infants and 5 preschool children in care. Family members residing in the home include 3 adults (licensee, licensee's husband, and licensee's daughter) and no minor children. Facility operation are Monday-Friday 7:30AM-5:30 PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the living room and bedroom #1(playroom). Children use the bathroom that is located in the playroom. Children have access to the living room and playroom. Off limit areas include bedrooms #2-4, bathrooms #2.5(upstairs), entire upstairs (barricaded by safety gate),laundry room (safety door knob), and garage (entry located in laundry room). The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under kitchen sink with safety latch), medicines (upper kitchen cabinet ) and hazardous items (sharp knives in kitchen drawer with safety latch) that can pose a danger to children. LPA observed a fireplace in the family room screened and safety latched. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in family room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2023

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WEERASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 197415660
	VISIT DATE: 06/02/2023

NARRATIVE

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Last Fire/Disaster Drill was completed on 10/03/2022. LPA reminded licensee a fire drill must be completed and documented every 6 months, including the time and date of each drill.

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch,snacks, and dinner are provided. Naps are provided on mats in the playroom.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. There is an outdoor air conditioner inaccessible to children with barricaded gate. LPA observed age appropriate toys. Per licensee, there are two pets on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 04/04/2024. Mandated Reporter expires 03/06/2025. There are no window cords accessible to children.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2023

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WEERASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 197415660
	VISIT DATE: 06/02/2023

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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee stated currently has child care insurance.

Licensee Weerasinghe was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee Weerasinghe 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.

No deficiencies have been cited at this time.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Chandrika Weerasinghe, along with her appeal rights and Notice of Site Visit.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2023

LIC809 (FAS) - (06/04)

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