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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846429
Report Date: 10/02/2023
Date Signed: 10/02/2023 01:39:44 PM

Document Has Been Signed on 10/02/2023 01:39 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:DE SILVA FAMILY CHILD CAREFACILITY NUMBER:
334846429
ADMINISTRATOR:DE SILVA,LASANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 675-0954
CITY:CORONASTATE: CAZIP CODE:
92881
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/02/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Lasanda De SilvaTIME COMPLETED:
01:50 PM
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On 10/2/2023 at 12:50 PM, Licensing Program Analyst (LPA) Claudia Caywood arrived at the facility to conduct a pre-licensing inspection to review corrections to a previous pre-licensing inspection. Present during this inspection were Lasanda De Silva, Licensee. LPA toured the facility and observed the and/or discussed:

The following has been corrected/completed:
.
1. LPA observed the pool fence handle which sits approximately 8 inches from the top of the fence and will suffice for the department requirement.
2. Poisons have been key locked in accordance with Title 22 regulations
3. Emergency Disaster Plan lists a second temporary relocation
4. Stairs have been properly barricaded to met the departments requirement

Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC 809/LIC 9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.

Exit interview conducted and report reviewed with the Licensee, Lasanda De Silva.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2023
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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