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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492889
Report Date: 03/10/2025
Date Signed: 03/10/2025 11:53:00 AM

Document Has Been Signed on 03/10/2025 11:53 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KANNANGARA FAMILY CHILD CAREFACILITY NUMBER:
197492889
ADMINISTRATOR/
DIRECTOR:		KANNANGARA,ATHUDARACHCHIGEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 217-9877
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/10/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Athudarachchige KannangaraTIME VISIT/
INSPECTION COMPLETED:
12:08 PM
NARRATIVE
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced Proof of Correction (POC) inspection to the above facility on 3/10/2025.  LPA arrived at the facility at 11:15 AM, identified self and met with Athudarachchige Kannangara, Licensee who guided LPA on a tour of the facility. There were 6 day- care children present during today’s inspection.

During the case management visit conducted on 2/26/25, the following deficiencies were issued:

Type B- 102427(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. POC due date was 3/6/2025. Upon arrival LPA did not observe the day-care room or the outdoor area to be clean and orderly. The day-care room was not organized and the outdoor area has trash in the yard, toys scattered across the yard, poop in the grass and clothes around and under the play equipment. Per Licensee the children has not been outside today, LPA had a prior conservation with the Licensee regarding the day-care areas being clean and organized prior to the start of their business hours. Per Licensee, the gardener has not been been to the home, LPA explained the things that need to be done do not require a gardener. LPA took photos of the physical plant.

The following deficiency listed on the attached deficiency page is being cited in accordance with California Code of Regulations Title 22.

The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

An exit interview was conducted with the Licensee and Appeals Rights provided.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2025
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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Document Has Been Signed on 03/10/2025 11:53 AM - It Cannot Be Edited


Created By: Tatiana Bickham On 03/10/2025 at 11:44 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KANNANGARA FAMILY CHILD CARE
FACILITY NUMBER: 197492889

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2025
Section Cited
CCR
102417(b)

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(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
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Licensee will organize and clean the yard and day-care room. Licensee must ensure the day-care area is cleaned upon opening the day-care and during operating hours.
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LPA observed poop, trash, toys and clothes scattered in the backyard. LPA also observed the day-care room not to be organized. This 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.
SUPERVISOR'S NAME:Raul Navarro
LICENSING EVALUATOR NAME:Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2025


LIC809 (FAS) - (06/04)
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