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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418698
Report Date: 04/10/2023
Date Signed: 04/10/2023 11:54:44 AM

Document Has Been Signed on 04/10/2023 11:54 AM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WIJESUNDARA FAMILY CHILD CAREFACILITY NUMBER:
197418698
ADMINISTRATOR:WIJESUNDARA, JANAKIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 757-2628
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Janaki Wijesundara, LicenseeTIME COMPLETED:
12:00 PM
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On 4/10/2023 10:15 AM, Licensing Program Analyst (LPA) Adrian Risher conducted an unannounced Annual visit. LPA met with Janaki Wijesundara, Licensee and toured the facility inside and out. There were 4 children present at the time of the inspection. Hours of operation are Monday thru Saturday 7am to 12am

The single family home has 3 bedrooms and 2 bathrooms. The daycare will consist of the living room, kitchen, Bedroom 2 and Bedroom 3. The living room is used for daily activities. The children eat in the kitchen. Bedroom 2 is used for the infants to nap. Bedroom 3 is used as a play room. Licensee is using playpens and cots for napping. These areas were inspected by LPA. The other bedrooms and rooms are considered off-limits and inaccessible.

LPA inspected the bathroom and did not observe any medications or poisons that could pose a potential risk to children in care. The kitchen was inspected during the visit. LPA did not observe any knives or sharp objects, detergents or cleaning supplies that would pose a potential risk to children in care. These items were made inaccessible to the children.

LPA observed age appropriate toys, furniture and activities for children while in care at the facility. LPA did not observe any bodies of water. The outside play area is gated all around.

LPA observed a charged fire extinguisher (2-A:10-B:C). LPA observed operable smoke detector and carbon monoxide detector. Licensee has a first aid kit which includes band aids and a thermometer. The home has central air and heat. There are no firearms on the premises. There is one dog in the home.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE: DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2023
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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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: WIJESUNDARA FAMILY CHILD CARE
FACILITY NUMBER: 197418698
VISIT DATE: 04/10/2023
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Licensee has current CPR, first aid, health and safety which expires 07/2023. Mandated reporter training was completed on 05/27/2022. Staff and children's files were reviewed during inspection. LPA reviewed records related to earthquake drills and fire drills which were found to be current. All required Child Care Postings was observed on the Parent Board during inspection.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 Janaki Wijuseundara

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023
LIC809 (FAS) - (06/04)
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