334840727-2-25-2020-10-CC-SBRR-BM5UMZ-20200225144311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334840727
Report Date: 02/25/2020
Date Signed: 02/25/2020 02:43:29 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	JAYASINGHE FAMILY CHILD CARE		FACILITY NUMBER:	334840727
ADMINISTRATOR:	JAYASINGHE, RANJANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 746-3256
CITY:	MENIFEE	STATE: CA	ZIP CODE:	92584
CAPACITY:	14	CENSUS: 8	DATE:	02/25/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Ranjani Jayansinghe, Licensee		TIME COMPLETED:	02:55 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	(2) On 02/25/2020 at 11:10 AM, Licensing Program Analyst (LPA) Susan Brewer, arrived at the facility for the purposes of conducting a random annual inspection. LPA was greeted by the Licensee’s Staff Assistant #1 and granted entry to tour the facility, inside and out. LPA took a census of 6 children present upon arrival. At 11:18 AM, the Licensee Ranjani Jayansinghe, arrived at the facility with two additional day-care children, bringing the census up to 8. Facility records were reviewed and the following was observed and/or discussed: Normal days and hours of operation are: Monday through Friday, 4:00 AM to 11:30 PM OFF-LIMIT AREAS INCLUDE: Garage, Laundry Room and Entire 2^nd Floor. · The facility is operating within the licensed capacity and appropriate ratios. · Appropriate supervision provided during inspection – when temporarily away from the home, the Licensee shall arrange for a substitute adult to care for and supervise children in their absence. · A working telephone is present on 02/25/2020. · Appropriate fire extinguisher, smoke detector and carbon monoxide detector present and were tested by the applicant during this inspection on 02/25/2020. · All hazardous items inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children. · Storage of poisons is inaccessible to children and locked in Garage. · No guns or weapons present as stated by the Licensee Ranjani Jayansinghe. LICENSEE UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS. · Stairs are barricaded with a gate. · Verification of control of property on file

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JAYASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 334840727
	VISIT DATE: 02/25/2020

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
26
27
28
29
30
31
32

· Property owner/landlord notification and consent on file.
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted on 02/25/2020.
· Pediatric CPR and First Aid Training Completed on 05/02/2019, Staff 1 on 11/01/2019, Staff 2 on 05/02/2019; Cards expire on 05/2021 and 11/2021.
· Health & Safety Certificate – Licensee completed on 08/15/2009, however, at 12:15 PM LPA reviewed facility files and the licensee failed to provide proof of health/safety & nutrition certificates for assistants. Staff 1 was left to supervise day-care children in the licensee's absence on 02/25/20.
· No bodies of water on 02/25/2020. LICENSEE UNDERSTANDS ALL BODIES OF WATER INCLUDING PONDS, ABOVE GROUND POOLS & SPAS, IN-GROUND POOLS & SPAS, AND SOME FOUNTAINS MUST BE PROPERLY COVERED OR FENCED PER TITLE 22 REGULATIONS. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Fireplace is properly barricaded on 02/25/2020.
· The home is clean and orderly with proper heating and ventilation for safety and comfort
· Outside play area is properly fenced or the Licensee maintains appropriate supervision, however, while inspecting the outside play area at 11:47 AM LPA S. Brewer, observed 5 fruit trees with thorns that do not have a fence or barricade. 11:53 PM, LPA observed the outside gas grill to have a broken door that would cover the gas line. The opening to the door is at ground level which makes it accessible to children in care, however children were not outside. The ground under the swings and slide, are developing deep grooves in the ground and do not have adequate cushion for fall.
· Current roster on file, verified on 02/25/2020.
· Documentation of fire drills on file. The last file drill conducted was on 02/11/2020 at 1:45 PM, 12 children present, lasted 5 minutes and exited the back yard.
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. Resident and/or staff records reviewed on 02/18/2020, indicate that all adults who require caregiver background checks have received all required clearances or exemptions.

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

Page: 2 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JAYASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 334840727
	VISIT DATE: 02/25/2020

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
26
27
28
29
30
31
32

· Facility is not currently providing IMS Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

The following was reviewed with the licensee(s):
- SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.

- AB290 – Child Nutrition, effective January 1, 2016 - – In accordance with California Health and Safety Code Section 1596.866 - each family day care home licensee who provides care, shall have at least one hour of childhood nutrition training as part of the preventive health practices course or courses.

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

Page: 3 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JAYASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 334840727
	VISIT DATE: 02/25/2020

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
26
27
28
29
30
31
32

- SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1597.622(a)(1) - a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination or they may provide a statement declining the vaccination. If employees/volunteers are receiving the influenza vaccination they must do so between August 1 and December 1 of each year.
- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For an Immediate Risk violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Immediate Risk violations the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
- AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – The Licensee Ranjani Jayansinghe completed the training on 06/26/2018, Staff 1 completed on 02/26/2018 and Staff 2 completed on 02/23/2020. In accordance with California Health and Safety Code Section 1596.8662 – 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. Applicants must meet requirements as a precondition to licensure. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days to complete training as required. This training requirement may be directly met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ and are provided in English and Spanish. If no training is made available in a required person’s primary language then those persons shall be exempt from this requirement.

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

Page: 4 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JAYASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 334840727
	VISIT DATE: 02/25/2020

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
26
27
28
29
30
31
32

- AB2370 – Effective January 1, 2019 – Lead Poisoning – providers are required to provide a lead toxicity prevention handout to parents/guardians of newly enrolled and newly reenrolled children with information on risks and effects of lead poisoning; blood lead testing recommendations and requirements; and options for obtaining blood lead testing, including free and/or discounted testing. There will be a training component of this added to the Preventative Health Training beginning July 1, 2020.
- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The applicant is urged to visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.

- Please subscribe at www.childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

Page: 5 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JAYASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 334840727
	VISIT DATE: 02/25/2020

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
26
27
28
29
30
31
32

See LIC809D for Type B cited deficiency.

Appeal rights discussed and a copy of this report was provided to the licensee on this date.

No Civil Penalty has been assessed during this inspection.

During the exit interview, the LICENSEE, Ranjani Jayansinghe, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

A copy of this report was reviewed and provided to the licensee Ranjani Jayansinghe, on 02/25/2020 and must be made available to the public upon request for the next 3 year

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

Page: 6 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JAYASINGHE FAMILY CHILD CARE	FACILITY NUMBER: 334840727
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/25/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/25/2020 Section Cited	1 2 3 4 5 6 7	102416 Personnel Requirements: (c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric CPR & 1st Aid pursuant to Health and Safety Code Section 1596.866. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	On 02/25/2020 at 11:10 AM LPA Susan Brewer, observed Staff 1, supervising 6 day-care children in the absence of the licensee Ranjani Jayasinghe, and Staff 1, has not completed the Health/Safety/Nutrition Training, which poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Telma Sandoval	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

Page: 7 of 7