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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197414572
Report Date: 11/17/2025
Date Signed: 11/17/2025 09:46:58 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/20/2025 and conducted by Evaluator Elicia Calvillo
COMPLAINT CONTROL NUMBER: 58-CC-20251020165256
FACILITY NAME:KIDSVILLE U.S.A.FACILITY NUMBER:
197414572
ADMINISTRATOR:PERERA, MAUREENFACILITY TYPE:
850
ADDRESS:8472 CORBIN AVENUETELEPHONE:
(818) 886-3508
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:72CENSUS: 25DATE:
11/17/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Brittany Wijesekera, Assistant DirectorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff falsifying records.
INVESTIGATION FINDINGS:
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On 11/17/2025 at 08:45 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced complaint investigation visit to deliver findings on the above-mentioned allegations. LPA identified self and met with Brittany Wijesekera, Assistant Director, who guided analyst on a tour of the inside and outside of the facility. LPA observed 25 children and 4 staff upon arrival.

Throughout the course of the investigation, LPA obtained the LIC 9040 Child Care Facility Roster, LIC 500 Personnel Report, interviewed Director, interviewed Assistant Director, interviewed staff, interviewed parents, and obtained other pertinent documents.

During today’s visit, LPA addressed the allegations per Reporting Party that the staff is falsifying records.

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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 58-CC-20251020165256
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KIDSVILLE U.S.A.
FACILITY NUMBER: 197414572
VISIT DATE: 11/17/2025
NARRATIVE
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Per Director and Assistant Director, staff are not allowed to sign documents on behalf of parents. When a parent’s signature is missing the Director or Assistant Director will ask the parent to sign the document.

During interviews with staff, there were no disclosures made regarding the allegations.

During interview with parents, there were no disclosures made regarding the allegations.

Based on the allegation there were no children interviews conducted.

Based on LPA investigation, documents obtained, and statements obtained, it has been determined that the complaint allegation staff is falsifying records, is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are unsubstantiated.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Brittany Wijesekera, Assistant Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025
LIC9099 (FAS) - (06/04)
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