197417035-3-24-2023-12-CC-JTAO-CQ8VDM-20230324162057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417035
Report Date: 03/24/2023
Date Signed: 03/24/2023 04:21:04 PM

Document Has Been Signed on 03/24/2023 04:21 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:	ATURUGIRIGE FAMILY CHILD CARE		FACILITY NUMBER:	197417035
ADMINISTRATOR:	ATURUGIRIGE, INDRANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 367-6543
CITY:	SANTA CLARITA	STATE: CA	ZIP CODE:	91390
CAPACITY:	14	CENSUS: 0	DATE:	03/24/2023
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:35 PM
MET WITH:	Indrani Aturugirige, Licensee		TIME COMPLETED:	04:30 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 03/23/23 Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Indrani Aturugirige, who guided analyst on a tour of the facility for the an Annual/Random inspection. This is a two story, 4 bedroom, 2.5 bathroom home with kitchen/dining, family room, living room, laundry room and converted 3 car garage into classroom (Proof of Permit shown to LPA). There is no pool/spa or body of water on the premises. Upon arrival LPA observed 0 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 6:30AM-5:30PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the classroom. Children use the bathroom in hallway on the left. Children only have access to the classroom. Off limit areas include all bedrooms, bathrooms #1.5 (upstairs), laundry room (safety door knob), and 2 car garage (has a key lock door knob). 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 upper kitchen cabinet unreachable to children in care) that can pose a danger to children. LPA observed the fireplace in the living room to be screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (3A40BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible. LPA reminded licensee no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment are allowed on the premises. There is a designated area for ill children as necessary by entrance area. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (landline and cell).

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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: ATURUGIRIGE FAMILY CHILD CARE	FACILITY NUMBER: 197417035
	VISIT DATE: 03/24/2023

NARRATIVE

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Fire/disaster drill is maintained current. Last Fire/Disaster Drill was completed on 11/17/2022.

Roster complete and maintained current.

Bathroom: LPA observed a hole from a water leak in the day care bathroom. Per licensee, it happened last week on 03/13/23. LPA reminded licensee she must report any unusual incidents to the department within 24 hours, and send the LIC624B (Unusual Incident Report) to the Department within the 7 day time frame. Licensee will have the child care bathroom fixed before she accepts older day care children (preschool and school age). Shower/tub are free of hazards (child care 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. At this time, licensee does not have any preschool children enrolled. Naps are provided in the main care area. LPA observed mats in the main care area.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. Per licensee, the backyard has not been in use due to the weather, and licensee does not have older children enrolled. LPA reminded licensee outdoor air-conditioner must be barricaded before school age children or preschool children can access the backyard. Per licensee she has a safety gate for the outdoor air-conditioner. LPA observed age appropriate toys. Per licensee, there is one pet on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expire 04/17/2023. Mandated Reporter expired on 01/30/2021. Licensee will retake the mandated reporter training at www.mandatedreporterca.com and send proof of completion to LPA Tamayo no later than 04/07/23. 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: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: ATURUGIRIGE FAMILY CHILD CARE	FACILITY NUMBER: 197417035
	VISIT DATE: 03/24/2023

NARRATIVE

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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and LIC 9227 (Individual Sleeping Plan). Licensee has no children in care during the inspection, however, one file was reviewed for information. Licensee stated currently has child care insurance.

Licensee Aturugirige 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 Aturugirige 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 Indrani Aturugirige, 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: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

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