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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494574
Report Date: 08/12/2020
Date Signed: 05/03/2021 07:35:06 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:DEVONSHIRE PRESCHOOLFACILITY NUMBER:
197494574
ADMINISTRATOR:MARIAN RATNAYAKEFACILITY TYPE:
850
ADDRESS:21203 DEVONSHIRE STREETTELEPHONE:
(818) 700-2821
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:60CENSUS: 0DATE:
08/12/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
07:00 PM
MET WITH:Marian Ratnayake & Dharshana Ratnayake/OwnersTIME COMPLETED:
09:00 PM
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 Licensing Program Analyst (LPA) Silva Garibyan met with owner/applicants Marian Ratnayake & Dharshana Ratnayake to conduct a pre-licensing/Change of Ownership inspection. The applicants submitted application for 60 preschool age children ages 2 years to entry to first grade . Applicants provided a tour of the facility at 7:00 p.m. on 08/12/2020. The facility will operate a Preschool program in rooms #1, #2, #3, #4, #5, and #6. The fire department has granted the fire clearance for the capacity of 60 children. Fire Clearance granted on 07/29/20 by Inspector Cindy Struck, LA City Fire Application was submitted for a Preschool license and for Infant license ( Facility # 197494575). All programs will be measured and considered for licensing today. Control of property was verified with a copy of the Commercial Lease Agreement.
LPA toured the facility inside and outside. There are six classrooms assigned for the preschool program.
The following are the measurements:
Preschool Indoor:
Classroom #1 ( Blue Carpet) : 13 x 19.5 = 253.5 sq. ft
Classroom #2: ( 18.5 x 17.5) + ( 30.5 x 10) - ( 4.9 x 8.5) - ( 2.8 x 2.6) = 579.82 sq. ft
Classroom #3: ( 16.3 x 11.9) + ( 11 x 11.6) + ( 11.4 x 11.1) = 448.11 sq. ft.
Classroom #4: ( 11.1 x 11.1) + ( 6.1 x 11.3) + ( 7.5 x 10.4) + ( 11.6 x 13) + ( 4.5 x 4.9) = 442.99 sq. ft.
Classroom #5: 8.3 x 20 = 166 sq. ft.
Classroom #6: 17 x 13.9 = 236. 3 sq. ft.
Total indoor measurement for preschool : 2,126.2 sq ft. / 35 = 60 preschool children

Preschool outdoor measurement:

Preschool outdoor: ( 17.1 x 18.3) + ( 14.7 x 27.9) + ( 48.9 x 58.2) + ( 8 x 17) + ( 37 x 16) + ( 17 x 7.5) + ( 8 x 19) + ( 13 x 68) = 5,460.54 sq. ft./75= 72 children Continued
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2020
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DEVONSHIRE PRESCHOOL
FACILITY NUMBER: 197494574
VISIT DATE: 08/12/2020
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Based on the total 5 toilets and 7 sinks available for children's use, the facility accommodates 75 children.
Napping Equipment: Cots and mats are available for children in care. Cots and mats are equipped with sheets. Children will nap in individual classroom and napping equipment can be properly stored for safety.

Staff/Children Files: LPA observed all CCLD forms (blank) in files. Staff files were observed with sections for personnel, qualifications and evaluations. Children files were observed with sections for admissions agreement, immunization, medication consent, and authorizations.

The facility will provide breakfast, lunch, and two snacks. Menus are posted. There is a kitchen on site. The kitchen is equipped with a refrigerator, freezer, sink and microwave oven. The kitchen has cold and hot running water. The kitchen will be off limits to children in care.

Postings: LPA observed bulletin board outside the director's office for parents. Bulletin board will contain school updates and required postings by licensing (Facility License, Emergency Disaster Plan, Parents Rights Poster, Personal Rights Form)

Medication: All medication will be located in the Director's office.

LPA observed the facility to be gated all around, safe, sanitary and in good repair. Isolation area is located in Directors office and equipped with a mat and cot for ill children. Separate toilet and sink ( inside the kitchen) were observed for sick children.



The following was discussed during this inspection:

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm Continued

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2020
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DEVONSHIRE PRESCHOOL
FACILITY NUMBER: 197494574
VISIT DATE: 08/12/2020
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Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Carrying out medical orders when the child’s physician has determined that a layperson can be trained and safely carry out the orders.

Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis, and measles. Influenza waiver was discussed.

Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

The licensee has been informed that all employees must be associated to the facility. If the licensee fails to have proof of a fingerprint clearance or fails to associate a previously cleared individual to the facility, a civil penalty of $100.00, per day the person has been present, will be assessed. The first violation is subject to the penalty for up to five days. If there is a subsequent violation in a 12 month period, the fine will continue for up to 30 days. The "Notification of Parent's Rights" (PUB394) was discussed with the licensee and the licensee was advised that it must be posted in an area of the facility accessible to parents.

Licensee was reminded it is the licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations.

The following is required to continue the processing of the application for capacity of 60 children:

1) A final review by LPA Garibyan

An exit interview was conducted and a copy of this report will be provided via email to licensee.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2020
LIC809 (FAS) - (06/04)
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