<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017303
Report Date: 06/07/2023
Date Signed: 06/07/2023 03:16:07 PM

Document Has Been Signed on 06/07/2023 03:16 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MENDIS FAMILY CHILD CAREFACILITY NUMBER:
198017303
ADMINISTRATOR:MENDIS, MANEL & ESHINIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 357-0760
CITY:MONROVIASTATE: CAZIP CODE:
91016
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
06/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Manel Mendis LicenseeTIME COMPLETED:
03:25 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
Licensing Program Analyst (LPA) Cynthia Reyes conducted an unannounced annual required inspection. Licensing staff met with Manel Mendis, Licensee, who guided the LPA on a tour of the home. There was 3 children in care & licensee husband was also present on this date. Licensee's primary language is "Sinhala"
Family members residing in the home are the 3 adults, licensee, husband and son (criminal record clearance on file) and 0 children. This is a single story home which consists of 4 bedrooms, 3 bathrooms, living room, kitchen, dining room, and a converted garage, adjacent to the dining room area, which is used as a children's activity area. Children have access to the converted garage (No eating or sleeping), living room, dining room, kitchen, one (1) bedroom used for napping, and back yard outdoor play area. Children utilize the bathroom located within the activity room. The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service (land line). The home has a wall heater which is barricaded to prevent access to children and a window air conditioner. Per facility sketch, areas off-limits to children in care, are the additional three (3) bedrooms, and two additional bathrooms.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There are toys & Napping equipment available for children. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. All food items are prepared by/in the home. Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicates fully charged, serviced 04/03/23.

Children use backyard for outdoor play, not the front yard. The outdoor play area was observed to be fenced. LPA did not observe any objects that could be hazardous to children in care. No bodies of water on the premises.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2023
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MENDIS FAMILY CHILD CARE
FACILITY NUMBER: 198017303
VISIT DATE: 06/07/2023
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
Page 2

Licensing staff observed the following required posted documentation in the playroom: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill documented was 01/17/2023. Licensee states that there are currently 05 children enrolled, children's roster was reviewed and is current.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the family room, if necessary, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

Infant Care: The facility has infants in care.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, LPA(s) did not observed Immunization's in any of the children's files, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights,



Staff records were reviewed, licensee has Pediatric First Aid and CPR. Licensee and husband has current mandated reporter certificate on file. LPA reviewed the LIC 508- Criminal Record Statement. Licensee & husband doesn't have Proof of immunization's against measles. Influenza or influenza declination is on file for both, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate are on file.

Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medications. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Report continues on next page
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MENDIS FAMILY CHILD CARE
FACILITY NUMBER: 198017303
VISIT DATE: 06/07/2023
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
Page 3

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.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com. The Licensee will complete the training.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

LPA advised the licensee how to access forms and regulations on line at: www.ccld.ca.gov.

There are no deficiencies being cited. Technical violations were issued.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee's, Manel & Eshini Mendis.

*END OF REPORT

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3