198400574-8-29-2024-54-CC-ACAR-D8LVJ4-20240829162806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400574
Report Date: 08/29/2024
Date Signed: 08/29/2024 04:28:17 PM

Document Has Been Signed on 08/29/2024 04:28 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	RANAWEERA FAMILY CHILD CARE		FACILITY NUMBER:	198400574
ADMINISTRATOR/ DIRECTOR:	GISHANI RANAWEERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	7147238727
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 7	CENSUS: 7	DATE:	08/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:45 PM
MET WITH:	Gishani Ranaweera		TIME VISIT/ INSPECTION COMPLETED:	04:40 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	On August 29, 2024, at 2:45PM Licensing Program Analysts (LPAs) A. Carter and T.Tran conducted an Unannounced Required Annual Inspection and met with Licensee, Gishani Ranaweera . LPA disclosed the purpose of the inspection and was granted entry unto the facility by the licensee. There are 4 adult living in the home. All adults in the home were found to have criminal record clearance. There were seven day-care children present during today’s inspection. Licensee states that there are currently seven children enrolled. The children's roster was reviewed and is current. Licensee reports that the facility’s hours of operation are Monday thru Friday from 6:30am -6:00pm. Per Licensee, there are no children enrolled who require overnight care at this time. The Parent Board had the following documents posted: · License · Parent's Rights · Earthquake Preparedness · Emergency Disaster Plan The Disaster Drill log was current with the last drill conducted on June 12, 2024. The valve on the required 2A 10BC fire extinguisher indicates fully charged with purchase date of: 7/15/24. LPAs observed smoke and carbon monoxide detectors to be in operable condition. Per Licensee, First Aid kit is kept in the day-care area, observed by LPA. This is a single story home which consists of 2 bedroom, 2 bathroom, kitchen, living room and family area. Childcare is mainly conducted in the family room. Isolation area for sick children waiting to be picked up is in the living room area closest to the door, supervised and away from the other children. LPAs observed age appropriate toys and other age-appropriate material available such as alphabet charts, circle time area, toddler size tables and chairs, books for reading, cars, and play mats. LPAs observed age appropriate toys, free of loose and sharp parts. Page 1 of 3

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RANAWEERA FAMILY CHILD CARE	FACILITY NUMBER: 198400574
	VISIT DATE: 08/29/2024

NARRATIVE

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Children in care will have access day care area, one bathroom(located in the day-care area) and backyard. Per licensee, areas off limits to children and parents include both bedrooms and one bedroom. Per licensee, off limit areas are locked during operating hours making it inaccessible to children in care. Per licensee she provides breakfast, lunch, and snacks for children in care. Licensee states at this time she does not have any children with allergies. LPAs reminded Applicant that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. The home maintains telephone service via cell phone. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked.
Per licensee, the children will have access to half of the backyard area. LPA observed a playhouse, slide, and other age appropriate toys.. LPA observed backyard has grass and adequate perimeter fencing through-out the yard and all trees, shrubs, and plants are maintained.
Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months)
Licensee records were reviewed for approved Pediatric First Aid and CPR certification, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

—CPR Card valid until:12/24

—Mandated Reporter AB1207 Completed: 12/25

LPA did not observe any pets and Licensee confirms she has no pets at time of inspection. Per Licensee, there are no weapons, or firearms in the home and there are no bodies of water around the premises. Per licensee, there are no bodies of water. LPA did not observe any bodies of water around the premises at time of inspection.

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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RANAWEERA FAMILY CHILD CARE	FACILITY NUMBER: 198400574
	VISIT DATE: 08/29/2024

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Childcare Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
LPAs discussed the safe sleep regulations with licensee and discussed the Childcare 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.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
During the exit interview, the LICENSEE Gishani Ranaweera, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Type B deficiency was cited. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Gishani Ranaweera.
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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Andrea Carter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 08/29/2024 04:28 PM - It Cannot Be Edited

Created By: Andrea Carter On 08/29/2024 at 04:12 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RANAWEERA FAMILY CHILD CARE	FACILITY NUMBER: 198400574
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

This requirement is not met as evidenced by: Record review, licensee failed to obtain safe sleep record for C5.
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/13/2024
	Plan of Correction
1 2 3 4	Licensee agrees to have C5 parent complete the individual safe sleep plan then submit to LPA by 9/13/24 in order to clear this citation.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Denise Gibbs

LICENSING EVALUATOR NAME:

Andrea Carter

LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC809 (FAS) - (06/04)

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