197419620-9-16-2019-12-CC-MRAN-BG4RA7-20190917125038

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197419620
Report Date: 09/16/2019
Date Signed: 09/16/2019 03:17:29 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2019 and conducted by Evaluator Victoria Hunt

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20190620163230

FACILITY NAME:	GARUSINGHE FAMILY CHILD CARE		FACILITY NUMBER:	197419620
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	09/16/2019
		UNANNOUNCED	TIME BEGAN:	12:31 PM
MET WITH:	Kushani Garusinghe, Licensee		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Allegation #1: Adult in home force fed day care child
Allegation #2: Adult in home administers unknown substance to child(ren) in care
Allegation #3: Adult in home inappropriately handled day care child
Allegation #4: Day care provider is absent from the facility for more than the allotted time
Allegation #5: Provider failed to meet day care child's needs

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Hunt conducted a subsequent unannounced complaint inspection for the purpose of conducting additional interviews and to conclude the allegation findings. During the initial visit the LPA was granted access to the facility by licensee's assistant, the licensee, Kushani Garusinghe arrived shortly after. Upon arrival LPA observed 3 children ( one infant child, and two children over the age of 2 years old), and 1 staff present. This investigation consisted of interviews with: the licensee, witnesses, staff, children, and other pertinent parties relevant to the investigation. The investigation revealed the following evidence:

The licensee and staff denied that the allegations occurred. There were no witnesses or disclosures made from individuals interviewed during the course of this investigation to corroborate the complaint allegations. Therefore, based on the information obtained and the evidence gathered the allegations are deemed unsubstantiated. A finding that the complaint is unsubstantiated means - although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the allegations occurred.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2019

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 1