197414315-3-22-2023-12-CC-AALH-CQ6PP2-20230322112849

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197414315
Report Date: 03/22/2023
Date Signed: 03/22/2023 11:29:09 AM

Document Has Been Signed on 03/22/2023 11:29 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	GARUSINGHE FAMILY CHILD CARE		FACILITY NUMBER:	197414315
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	03/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Licensee Garusinghe Sujani		TIME COMPLETED:	11:50 PM

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On 03/22/23 Licensing Program Analyst (LPA) Andrew Alemoh met with licensee, Garusinghe Sujani who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPA observed 1 infant in care with licensee. Family members residing in the home include 2 adults (licensee, licensee's husband and licensee's two minor children). This is two story home with 3 bedroom and 3 bathroom. Facility hours of operation are Monday - Friday 7AM- 5:30 PM. Depending on parents requests operation hours may extend to 6:30 PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the playroom. The children use the bathroom located in the hallway to the left. The off-limits areas are all upstairs (barricaded by a baby gate), all bedrooms, two restrooms, and second living room area. Laundry room and garage are also off limits and are kept locked during business hours. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the garage, medicines which are not present in the home and hazardous items (sharp knives are kept in the kitchen in the upper cabinet high enough that they are inaccessible to children. Fireplace was barricaded by a black fence .

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARUSINGHE FAMILY CHILD CARE	FACILITY NUMBER: 197414315
	VISIT DATE: 03/22/2023

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Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the living room. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 03/22/23.

Bathroom: LPA observed the children's bathroom to be clean and orderly. There is no shower. Toilet and faucet are clean and operable. LPA observed the cabinets underneath the bathroom sink to have safety latches.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. LPA observed an alcohol shelf on the right side of the kitchen high enough making it inaccessible to children. LPA observed kitchen cabinets to have safety latches. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the garage which is locked during business hours. Per licensee day care children bring there own food to the day care home. Licensee stated she currently does not have a food program. Naps are provided in cribs the playroom and living room.

Outdoor: The front yard is off limits. The backyard is completely fenced in with a green fence all around. There is one small dog on the premises. LPA observed age appropriate toys, well secured and safe for children. The AC unit and BBQ pit were observed to be fully covered.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARUSINGHE FAMILY CHILD CARE	FACILITY NUMBER: 197414315
	VISIT DATE: 03/22/2023

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Per licensee she has not brought children out in the backyard due to the weather being cold. Licensee admits she intends to bring children out in the backyard when the weather is nicer. There are no bodies of water on the premises.

Advisory/Other: First Aid kit was observed in the children's bathroom with supplies readily available. CPR/First Aid expires 07/24. Mandated Reporter has expired. LPA reminded licensee; mandated reporter/CPR training must be completed every 2 years.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have child care insurance.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee Sujani and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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