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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198018391
Report Date: 11/16/2022
Date Signed: 11/16/2022 11:21:30 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/07/2022 and conducted by Evaluator Alicia Mooberry
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20221107085300
FACILITY NAME:ATAPATTU DHARMASENA FAMILY CHILD CAREFACILITY NUMBER:
198018391
ADMINISTRATOR:ATAPATTU, THANUJAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 924-1326
CITY:HAWAIIAN GARDENSSTATE: CAZIP CODE:
90716
CAPACITY:14CENSUS: 4DATE:
11/16/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Thanuja Atapattu, LicenseeTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Facility yard is unsafe for children in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounce complaint inspection for the purpose investigating the above allegation. LPA met with Thanuja Atapattu, Licensee who guided LPA on a tour of the faciilty. There were 4 children and Maheshi Atapattu, Assistant present during this inspection.

Reporting Party, RP, has provided evidence from local city zonig department which deemed wooded enclosure build by the licensee to be unpermitted and unsafe for use. LPA conducted interview with Licensee who confirmed that the enclosure in the front yard was used by children in care and was not approved by the city prior to use. During this inspection, LPA observed that the licensee has removed the wooden enclosure.

Based on evidence obtained and the licensee's own admittance, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22, 1102416.3(b) is being cited on the attached LIC 9099-D. ---- Report Continues on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
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 3
Control Number 54-CC-20221107085300
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ATAPATTU DHARMASENA FAMILY CHILD CARE
FACILITY NUMBER: 198018391
VISIT DATE: 11/16/2022
NARRATIVE
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The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview conducted with the Licensee, during which appeal rights were given and explained. Appeal Rights were discussed and a copy was provided.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20221107085300
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ATAPATTU DHARMASENA FAMILY CHILD CARE
FACILITY NUMBER: 198018391
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/16/2022
Section Cited
CCR
1102416.3(b)
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1102416.3 Alterations to Existing Buildings or Grounds (b) The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.
This requirement was not met as evidenced by:
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LPA observed that Licensee has removed the wooden enclosure previously used for play space of children in care. The licensee will provide a plan of care and supervision for when children use the front yard for playtime.
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The licensee did not recevied a clearacne from the local building inspector prior to constructing wooden enclosure used by children in the front yard.
This poses a potential risk to the health and safety of persons in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3