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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336300784
Report Date: 08/16/2024
Date Signed: 08/16/2024 09:57:06 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/24/2024 and conducted by Evaluator Kelli Waters
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240524135400
FACILITY NAME:DASANAYAKA FAMILY CHILD CAREFACILITY NUMBER:
336300784
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
08/16/2024
UNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:Wasanthi DasanayakaTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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-Staff spoke inappropriately to day care child in care.
-Staff hit day care child in care.
INVESTIGATION FINDINGS:
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On 08/16/24, Licensing Program Analyst (LPA), Kelli Waters, made a subsequent unannounced complaint investigation visit to deliver the findings for the above referenced allegation. LPA met with Wasanthi Dasanayaka, Licensee, who was informed of the decision rendered.

On 05/24/24, a complaint was made alleging that S2, a staff member of the Dasanayaka Family Child Care, had spoken inappropriately to a child in care, (C1). It was also alleged that S2 hit C1 while in care. During the investigation, LPA conducted interviews with pertinent parties, and reviewed a Sheriff’s report and video footage provided by Tuscany Hills Elementary to the Lake Elsinore Sheriff’s Department. The report and video footage of the incident corroborated the allegations of staff using inappropriate language and hitting (C1) while in care. In addition, LPA interviewed a direct eyewitness, who was able to attest to the way S2 spoke to C1 as alleged.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 10-CC-20240524135400
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DASANAYAKA FAMILY CHILD CARE
FACILITY NUMBER: 336300784
VISIT DATE: 08/16/2024
NARRATIVE
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Based on confidential interviews, video footage and record review, the preponderance of evidence has been met and the allegation that a staff member spoke inappropriately to child in care and hit a child in care is SUBSTANTIATED. California Code of Regulations, Title 22, Section 102423(a)(4), is being cited on the attached LIC 9099D.

An exit interview was conducted, and a copy of this report was provided along with copies of the Appeal Rights were provided.

A Notice of Site visit was given, and Licensee Wasanthi Dasanayaka understands that it must remain posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20240524135400
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: DASANAYAKA FAMILY CHILD CARE
FACILITY NUMBER: 336300784
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/23/2024
Section Cited
CCR
102423(a)(4)
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102423 (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived...(4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation...or other actions of a punitive nature...

This requirement was not met as evidenced by:
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Licensee will read the Regulation 102423 and provide LPA a signed statement of understanding via email.
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Based on confidential interviews, video footage and record review, the Licensee did not ensure the protection of children's personal rights, specifically of C1, which posed an immediate health and safety risk to children 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.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3