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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314232
Report Date: 11/15/2023
Date Signed: 11/15/2023 10:52:49 AM

Document Has Been Signed on 11/15/2023 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:NANAYAKKARA, PRABATHFACILITY NUMBER:
304314232
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
11/15/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Prabath Nanayakkara (Licensee)TIME COMPLETED:
11:10 AM
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On 11/15/2023, Licensing Program Analyst (LPA) A. Silva conducted a case management inspection in response to licensee’s request for a capacity increase. LPA met with licensee Prabath Nanayakkara, who guided the LPA on a tour of the facility. LPA observed five children in the designated daycare area, including two infants, being supervised by the licensee and one assistant (S2). The facility was within licensed capacity and the required ratio. Licensee stated there is currently three adults and no minors. Licensee stated he is not currently registered with any Foster Care agency or holds a foster parent license. Licensee was reminded to notify the licensing office of any changes. A review of the facility personnel report summary indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

This is a single-story home with three bedrooms, two bathrooms, living room, den, kitchen, dining room, front yard (fenced), backyard (fenced), side patio (fenced) and garage. The licensee has designated the living room, den, one bathroom, and back yard as part of the day-care. The licensee has designated three bedrooms, one bathroom, the kitchen, the dining room, the front yard, the side patio and garage as the off-limits areas. The licensee has gates to delimit the childcare area/off limits areas. The licensee has a child proof safety gate at the entrance of the den leading to the steps. Off limits areas are inaccessible to the children in care. The licensee has also placed a safety gate at the entrance of the kitchen, making this area inaccessible to the children in care. The licensee acknowledged the children may never enter the off-limit areas, during operation hours. The licensee has a cell phone that is used for childcare. The licensee was informed if a cell phone is used for childcare, it must remain on the premises at all times during hours of operation. The licensee was informed and understands the home is to be free from smoking during hours of operation.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: NANAYAKKARA, PRABATH
FACILITY NUMBER: 304314232
VISIT DATE: 11/15/2023
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The home does not have a fireplace or open-face wall heater. Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. Poisons or hazardous items are inaccessible and none were observed. There are no bodies of water. The toys are age appropriate and in good condition for the potential ages served. Baby walkers, bouncers, jumpers, and similar items will not be used for children in care. Licensee stated there are no weapons or firearms on the premises. When firearms are present, they must be locked and stored separately from the ammunition. During today's inspection, the smoke detector and carbon monoxide were operable, and the fire extinguisher gauge showed green.

Licensee will use the backyard for children's outdoor activities. The back yard is appropriately fenced. LPA observed play equipment to be safe and free of hazards. Per licensee, he provides food for the children. LPA reminded licensee that if food is not provided and food is brought from the children’s homes, container shall be labeled with child’s name and properly stored or refrigerated. Per licensee, all children will nap in the living room. Licensee stated he provides linen and blanket for the children. The licensee stated the linen/blankets are washed weekly and or more often if necessary. The licensee understands that all playpens must be free from loose articles.

Licensee’s Mandated Reporter Training was current. EMSA approved Pediatric CPR and Pediatric First Aid was current for licensee and the assistant present. The licensee has a current roster of children in care. Children’s records for children present during the inspection were reviewed for compliance. The licensee has a current disaster drill log. LPA reviewed five children’s files. The LIC 9227 Individual Infant Sleeping Plan was reviewed with the licensee. The licensee understands that all infants 12 months and younger must have an LIC9227 and all infants 24 months and under must be checked every 15 minutes during sleep as indicated in the infant safe sleep regulations (copy of regulations provide). LPA advised the licensee how to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. The licensee was provided a copy of the safe sleep environment in Spanish titled ¿Como es un ambiente de sueno seguro? (the licensee stated his assistant can read in Spanish and the assistant corroborated it).

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: NANAYAKKARA, PRABATH
FACILITY NUMBER: 304314232
VISIT DATE: 11/15/2023
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LPA reviewed the following safe sleep best practices with the licensee:
Always place infants 12 months and younger on their backs to sleep
Use only a tight-fitting sheet on the crib or play yard mattress
Do not hang any items from the crib or above the crib
Keep loose bedding and soft items like blankets, pillows, and stuffed dolls out of the crib or play yard
Pacifiers may be used only if they do not have items attached to them and there is no recall
Avoid swaddling, overheating, and head covering in infants
The temperature of the room should be comfortable enough for a lightly clothed adult
Complete Individual Sleeping Plan LIC9227 for infants 12 months and younger
Conduct and document the 15-minute checks for all infants under 24 months

The LPA provided 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 facility representative 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.

Licensee was reminded that all adults 18 and over, 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 Child Care Family 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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: NANAYAKKARA, PRABATH
FACILITY NUMBER: 304314232
VISIT DATE: 11/15/2023
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Fire clearance granted on 10/18/2023.

During todays’ inspection, there were no deficiencies cited and the licensee was in compliance with California Code of Regulations Title 22 for operating a Family Child Care home.

A new license for operating a Large Family Child Care Home shall be issued upon final review and if additional information is needed, licensee shall be contacted.

After the inspection and exit interview were completed with licensee the report was reviewed and discussed. Appeal Rights was discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. Licensee was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
LIC809 (FAS) - (06/04)
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