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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 196216501
Report Date: 03/15/2023
Date Signed: 03/15/2023 02:03:53 PM

Document Has Been Signed on 03/15/2023 02:03 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:WALAWEDURAGE FAMILY CHILD CAREFACILITY NUMBER:
196216501
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
03/15/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:NAYANI WALAWEDURAGETIME COMPLETED:
02:20 PM
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On March 15, 2023 at 1 PM, Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced case management-license initiated inspection for the purpose of increasing the capacity. LPA met with licensee Nayani Walawedurage and advised her of the purpose for the inspection. Together with the licensee, LPA toured the home inside and outside. At the time of inspection licensee had 5 children in care along with licensee's husband.

This is a two story home with four (4) bedrooms and three (3) bathrooms. The licensee uses the living room, dining room, kitchen, downstairs bathroom, and backyard for day-care. The required documents that should be posted were observed to be mounted on the wall at the entrance of the home. LPA observed a secure gate at the bottom of the stairs preventing any children from accessing the second floor. During the inspection LPA observed sufficient age-appropriate toys and learning materials readily accessible to children. No bodies of water were present at the time of inspection.

During the inspection 4 children were observed to be napping in the living room area. The outdoor area was observed to be clean and free of hazardous/toxic items. The kitchen was also observed to be clean and free of hazards. The kitchen cabinets contain child proof locks, preventing children from having access. The regulatory fire extinguisher was observed to be mounted on the kitchen wall.

The Los Angeles County Fire Department granted a fire clearance on 02/14/2023.
The home meets Title 22 Division 12 requirements of a Large FCCH. Effective date of license is today, March 15, 2023.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee Nayani Walaweurage.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2023
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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