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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842842
Report Date: 01/14/2026
Date Signed: 02/25/2026 12:14:28 PM

Document Has Been Signed on 02/25/2026 12:14 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:DE SILVA FAMILY CHILD CAREFACILITY NUMBER:
334842842
ADMINISTRATOR/
DIRECTOR:		DE SILVA, CHAMALIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 583-3077
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
01/14/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:17 AM
MET WITH:Chamali De SilvaTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
NARRATIVE
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On 01/14/2026, Licensing Program Analyst (LPA) Peebles arrived unannounced to conduct a case management inspection regarding compliance with Title 22 regulations governing the operation of a Family Child Care Home (FCCH). LPA Peebles met with Licensee Chamali De Silva, who granted full access to the home. LPA Peebles informed Mrs. De Silva of the purpose of the visit. Present during the inspection were the licensee, and four (4) children in care. LPA confirmed that four (4) children are currently enrolled.

This case management inspection is directly related to an inspection that was completed on 12/17/2025. LPA Peebles and LPA Jesse Gardner conducted a comprehensive inspection of the facility, including all areas of the home, the second floor, and all designated off-limits spaces. LPAs were granted unrestricted access to each room and inspected all closets and storage areas.

During the inspection, LPAs did not observe women’s clothing, personal belongings, or any items indicative of a female adult residing in the home, with the exception of a single pink bathrobe. All closets contained only a small amount of men’s clothing, insufficient to indicate full-time occupancy by an adult male. No clothing, personal toiletries, or belongings associated with the licensee’s children were present in the home.

During interviews, the licensee initially stated that she resides in the home “10 days out of the month,” but later recanted and stated she stays at the home “here and there.” Confidential interviews further revealed that no individuals reside at the licensed address on a consistent basis. Additional interviews indicated that drop-off and pick-up are routinely conducted by an assistant rather than the licensee. Confidential information also disclosed that the licensee’s children attend school within another school district.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: Courtnee Peebles
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DE SILVA FAMILY CHILD CARE
FACILITY NUMBER: 334842842
VISIT DATE: 01/14/2026
NARRATIVE
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and that the licensee personally conducts daily drop-offs and pick-ups for her children. This routine results in the licensee being absent from the home for approximately 80% of operating hours.

The cumulative evidence demonstrates that the licensee does not reside at the licensed facility address. Title 22 regulations require that a Family Child Care Home operates within the provider’s own residence. Failure to reside at the licensed location constitutes a direct violation of Health and Safety Code section 1596.78(a), which defines a family day care home as a home that provides care “in the provider’s own home.” As a result, the licensee is in violation of the residency requirement and is therefore subject to forfeiture of the FCCH license.

Based on the information obtained through inspections, interviews, and observations, the licensee is being cited for violations of California Code of Regulations Title 22, 102417(a) Operation of a Family Child Care Home. The licensee’s failure to reside at the licensed address compromises regulatory compliance and the integrity of the FCCH program.

An exit interview was conducted with the licensee. A copy of this report, the LIC 809D, and Appeal Rights were provided. A Notice of Site Visit was issued and must remain posted for 30 consecutive days. This report will remain a matter of public record for three years.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: Courtnee Peebles
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 01/14/2026 10:59 AM - It Cannot Be Edited


Created By: Courtnee Peebles On 01/14/2026 at 10:40 AM
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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: DE SILVA FAMILY CHILD CARE
FACILITY NUMBER: 334842842

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/14/2026
Section Cited
HSC
102417(a)

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Operation of a Family Child Care Home The licensee shall be present in the home and shall ensure that children in care are supervised at all times… Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement was not met as evidenced by:
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Licensee has forfeited their license due to not residing in the home. Title 22 regulations states licensee must live in the home and be present 80% of operating hours daily.
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Based on interviews, and observations the licensee is not living in the licensed home and is not present for 80 percent of the operating hours which poses a potential Health, Safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Pauline Beschorner
NAME OF LICENSING PROGRAM MANAGER:
Courtnee Peebles
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/14/2026


LIC809 (FAS) - (06/04)
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