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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198017986
Report Date: 12/23/2024
Date Signed: 12/23/2024 04:12:35 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/26/2024 and conducted by Evaluator Stephanie Li
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240926092714

FACILITY NAME:KARUNARATNE FAMILY CHILD CAREFACILITY NUMBER:
198017986
ADMINISTRATOR:KARUNARATNE, DEEPANIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 221-6485
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:14CENSUS: 10DATE:
12/23/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee Deepani KarunaratneTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Licensee does not follow sanitary food practices
INVESTIGATION FINDINGS:
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Licensing program analyst (LPA) Stephanie Li conducted an unannounced site inspection to present the findings of the above complaint allegations. Licensing staff met with Licensee Deepani Karunaratne to whom the reason for the visit was explained. Licensee provided a tour of the facility. Present during the inspection was 3 adults staff and 8 children.

During the investigation licensing staff conducted interviews with licensee, assistant, parent and child. Licensing staff also obtained several documents related to the complaint allegation, including but not limited to a copy of the facility roster, parent contract, specialists contact into, and photos of documents from children’s files. Children files were also reviewed during this investigation.

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 33-CC-20240926092714
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KARUNARATNE FAMILY CHILD CARE
FACILITY NUMBER: 198017986
VISIT DATE: 12/23/2024
NARRATIVE
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Based on observations made and statements obtained from interviews, disclosures were made regarding licensee not following sanitary food practices, corroborating the allegation, therefore, the above allegation is deemed SUBSTANTIATED. California Code of Regulations, Title 22 are being cited on the attached LIC9099D.

Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

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

Exit interview was reviewed and appeal rights provided with Licensee Deepani Karunaratne.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20240926092714
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KARUNARATNE FAMILY CHILD CARE
FACILITY NUMBER: 198017986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/23/2024
Section Cited
CCR
101227(a)(1)
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(a) (1) All food shall be safe and...Title 7, Code of Federal Regulations, Part 226.20...All food shall be selected, stored, prepared and served in a safe and healthful manner.
This requirement was not met evidenced by:
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LPA's observed licensee to have children eat at patio tables for meals and snacks avoiding sweeping the space they are eating from during a previous visit. LIcensee will have children eat at tables indoors when weather permits them from eating outside.
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Based on observation and interviews, sweeping of floor after snacks was occuring while children were sitting and eating on the floor, which poses a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC9099 (FAS) - (06/04)
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