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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020540
Report Date: 04/22/2024
Date Signed: 04/22/2024 10:52:13 AM

Document Has Been Signed on 04/22/2024 10:52 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LEARNING PLACE PRESCHOOLFACILITY NUMBER:
198020540
ADMINISTRATOR/
DIRECTOR:
SHAMALIE GOONERWARDENEFACILITY TYPE:
850
ADDRESS:2041 W. GLENOAKS BLVD.TELEPHONE:
(818) 319-3010
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 22DATE:
04/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Bhagya Fernando, Owner of facilityTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 04/22/24, at 9:35 AM, due to an incident that occurred on Wednesday, 04/03/24. Upon LPA’s arrival to the facility LPA met with Enereyda Flores, director who guided analyst on a tour of the facility. At 9:50 a.m., Bhagya Fernando, Owner of facility arrived. During this inspection LPA observed 22 children were present in the facility with three staff.

Alleged Incident took place on Wednesday 04/03/24. Incident was reported via phone next working day. Original LIC 624 Unusual Incident/Injury Report form was received by the Department within 7 days. The written incident report was received by email on Thursday 04/04/24. The facility reported the incident within the required 24 hour time frame.

During this inspection LPA conducted interviews with two staff and child#1.

Based on Child#1 interview, no disclosure was made.
Based on staff#1 and staff#2 interviews, they did not observe any staff to handle child#1 or any child in an inappropriate or rough manner.

LPA issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the staff and children involved with the incidents documented in this report.

At this time, there is not a preponderance of evidence that shows that the facility was in violation with Title 22 Regulations when these incidents occurred. Therefore, there are no deficiencies being cited on this date.

The Notice of Site Visit (LIC 9213) 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 Bhagya Fernando, Owner of facility at 11:00 a.m..
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2024
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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