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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401107
Report Date: 08/22/2024
Date Signed: 08/22/2024 04:20:55 PM

Document Has Been Signed on 08/22/2024 04:20 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:MAHALEKAM FAMILY CHILD CAREFACILITY NUMBER:
198401107
ADMINISTRATOR/
DIRECTOR:		MAHALEKAM, UMANGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 841-1378
CITY:LAKEWOODSTATE: CAZIP CODE:
90713
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
08/22/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analysts (LPAs) Jonnisha Culbert and Randy Derraco conducted an announced pre-licensing inspection at the address mentioned above. LPAs met with Applicant Umanga Mahalekam. Applicant is currently licensed for a small family home and is requesting a capacity increase and to relocate. The purpose of the visit is to inspect the facility for a large family child care home and to relocate facility. LPAs provided Applicant with a prelicensing entrance checklist (LIC 9280). All individuals residing in the home were discussed and noted.

Per applicant, there are no firearms or registered sex offenders residing at home. Hours of operation are Monday - Friday 7am to 6pm. Ages care will be provided to are 0 to six years old.

This is a one story studio additional housing unit (ADU) located in the backyard of 4612 Adenmoor Ave Lakewood, CA, 90713. Per Applicant, children and parents will enter gate from drive way. Per Applicant, parents will walk children through the gate and backyard to the front door of ADU

On limits areas include the entire ADU and a section of backyard. Areas off limits to children includes a section of the enclosed backyard.

LPAs observed an enclosed backyard. Baby gates are used to section off two off-limits areas of the backyard. LPAs observed that gate on one side is not secure and a barbeque pit is behind it. LPAs advised Applicant to move barbeque pit or cover it to prevent access to children. LPAs observed a shaded backyard with child size tables, chairs, and toys.

Areas that will be used by children were inspected for safety, comfort, and cleanliness. Age appropriate toys are available to children. LPAs observed one play yard and 4 cots for sleeping. Per Applicant, there are three more play yards available. LPAs observed two children tables, four chairs, and one high chair for eating. Per


SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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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: MAHALEKAM FAMILY CHILD CARE
FACILITY NUMBER: 198401107
VISIT DATE: 08/22/2024
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per Applicant, there are four high chairs in total. Telephone service is a cell phone and will remain in the home during daycare hours. The studio is equipped with heating and air via wall unit. LPAs did not observe any wall heaters or fireplaces. The smoke and carbon monoxide detector (combination) was observed and is operable. LPAs observed 3A40BC Fire Extinguisher with a purchase date of 07/22/24 located on the wall near kitchen sink. LPAs did not observed cleaning products or poisons. Per Applicant, cleaning products are kept in a locked shed outside.

Per Applicant, parents will provide meals for children and she will provide snacks as needed. LPA advised Applicant that all meals brought from children's home must be labeled with child's name and properly stored.
All cabinets accessible to children were equipped with a safety latch. Per Applicant, knives will be kept in cabinet above kitchen sink. Covers were placed on all accessible electrical sockets except for in bathroom.

Bathroom/laundry room to be used for children was observed to be kept clean. Inside of bathroom, LPAs observed an expose dryer exhaust vent and cleaning equipment (mops, broom, dust pan), pipe sticking out of wall, and uncovered outlet in the corner of bathroom near sink. LPA advise applicant to remove equipment and cover area. Per Applicant, a cabinet will be place there to cover the pipe, socket, and vent.

Applicant has completed training on preventive health practices including Pediatric First Aid and CPR. The Applicant's Pediatric First Aid and CPR expires on 09/2025. LPA observed that Applicant has proof of the Mandated Reporter AB 1207 Training Certificate completed on 08/31/2024 and it is on file

Applicant 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, 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 Child Care 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.

Applicant provided proof of control of property


SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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: MAHALEKAM FAMILY CHILD CARE
FACILITY NUMBER: 198401107
VISIT DATE: 08/22/2024
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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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. PIN 22-05-CCP Page Eight Safe Sleep -

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed applicant 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.

On this date, 08/19/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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: MAHALEKAM FAMILY CHILD CARE
FACILITY NUMBER: 198401107
VISIT DATE: 08/22/2024
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication

Following correction are due by 08/29/2024
  • Remove Barbeque pit
  • Cover expose pipe, wall socket, and dryer vent hole in bathroom.
Exit interview conducted and report was reviewed with the Applicant Umanga Mahalekam.
Applicant was advised that once corrections are completed, approval of the application will be determined by the Department.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC809 (FAS) - (06/04)
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