<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700363
Report Date: 09/18/2024
Date Signed: 09/18/2024 12:32:45 PM

Document Has Been Signed on 09/18/2024 12:32 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KURUCULASURIYA FAMILY CHILD CAREFACILITY NUMBER:
195700363
ADMINISTRATOR/
DIRECTOR:		DINUSHI KURUCULASURIYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 825-3123
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/18/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Dinushi KuruclasuriyaTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) and Amelia Morales conducted an announced Plan of Correction (POC)/ 2nd pre-licensing inspection for a large family child care at the above facility on 09/18/2024 at 12:00PM. LPA met with Applicant Dinushi Kuruclasuriyai, who guided LPAs on a tour of the facility. There were no children present when LPA arrived. Per Applicant, hours of operation will be Monday through Friday, 7:30 AM to 5:30 PM. Applicant states they will provide care for children 2 to 5 years of age of age.

This is a single home consisting of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, laundry room backyard, and attached garage. The home was inspected for safety, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

The Applicant and LPA agreed the following was needed prior to Licensure:
  • Safety locks added to the cabinets in the dinning room.
  • Door locks added to the off-limits rooms.
  • Removal of planter in the living room.
  • 5ft gate installed around the fish pond.
  • Able to test smoke/carbon monoxide detectors.

LPAs observed all corrections have been made except for the gate in the backyard. There is a mesh gate around the pond in the backyard that measures at 5ft tall but on side of the right side of the gate it does not close, making it accessible to children. The gate also does not fully stand up on the left side, potentially making it accessible to children. Applicant agrees to add a lock to the right side of the gate and rearrange the left side of the gate so that it properly stands up.
Page 1.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KURUCULASURIYA FAMILY CHILD CARE
FACILITY NUMBER: 195700363
VISIT DATE: 09/18/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Once LPA receives proof of corrections for the gate, LPA will submit application for approval.

A notice of site visit was given to Applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Applicant Dinushi Kuruclasuriyai. Once licensed, the applicant is required to adhere to the terms and limitation as stated on the license.

Page 2.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2