304370870-7-26-2023-06-CC-PRIS-CU4MW8-20230726095748

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370870
Report Date: 07/26/2023
Date Signed: 07/26/2023 09:58:00 AM

Document Has Been Signed on 07/26/2023 09:58 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	A KIDS PLACE		FACILITY NUMBER:	304370870
ADMINISTRATOR:	PHEM, SANDY		FACILITY TYPE:	850
ADDRESS:	1180 SOUTH IDAHO ST. SUITE K		TELEPHONE:	(714) 626-0400
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	40	CENSUS:	DATE:	07/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Ranmal Jayasekara, Adm/Owner		TIME COMPLETED:	09:46 AM

NARRATIVE

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Licensing Program Analyst (LPA) P Rivas conducted an unannounced annual inspection and was met by Mr. Ranman Jayasekara who did not allow entrance into facility. LPA explained purpose for visit but was still not allowed entrance.

Licensee stated he did not want to allow LPA Rivas entry as his appeal dated 09/14/22 & follow up letter dated 03/31/23 under 304370871 had not received a response. As per licensee's statement.
The following deficiency is cited under the Health & Safety Code 1596.852 Any duly authorized officer, employee or agent of the department may, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation of this act or the regulations adopted by the department pursuant to the act.
LPA Rivas informed Ranmal Jayasekara, Adm/Owner that this report dated 07/26/2023 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Rivas informed to provide a copy of this licensing report dated 07/26/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: A KIDS PLACE	FACILITY NUMBER: 304370870
	VISIT DATE: 07/26/2023

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Exit interview conducted and report was reviewed with Ranmal Jayasekara, Adm/Owner. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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

end of report

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/26/2023 09:58 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: A KIDS PLACE	FACILITY NUMBER: 304370870
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/26/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/27/2023 Section Cited HSC 1596.852	1 2 3 4 5 6 7	Any duly authorized officer, employee, or agent of the department may, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation of, this act or the regulations adopted by the department pursuant to the act.	1 2 3 4 5 6 7	licensee states will allow entrance into facility when a reply is received in regards to appeal sent on 09/14/22 & follow up 03/31/23. LPA advised inspection authority is conducted without prior approval or consent of licenee
	8 9 10 11 12 13 14	Licensee did not allow LPA Rivas entrance into facility. This poses an immediate threat to the health, safety and personal rights to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023

LIC809 (FAS) - (06/04)

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