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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494575
Report Date: 08/25/2023
Date Signed: 08/25/2023 12:33:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/31/2023 and conducted by Evaluator Doris Whitmore
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230531154712
FACILITY NAME:DEVONSHIRE INFANT CENTERFACILITY NUMBER:
197494575
ADMINISTRATOR:JACQUELINE SORIA LOPEZFACILITY TYPE:
830
ADDRESS:21203 DEVONSHIRE STREETTELEPHONE:
(818) 700-2821
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:46CENSUS: 14DATE:
08/25/2023
UNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Marian RatnayakeTIME COMPLETED:
12:32 PM
ALLEGATION(S):
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9
Lack of Supervision- Infants in care are left unattended by facility staff
Qualifications- Unqualified staff are left alone to provide and supervision to infants in care
Reporting Requirements- Staff do not follow proper reporting requirements
INVESTIGATION FINDINGS:
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On 08/25/2023 at 10:05 a.m.Licensing Program Analyst (LPA) Doris Whitmore conducted an unannounced visit for the purpose of delivering findings for a complaint investigation regarding the allegations above. LPA spoke with Marian Ratayake and there were 14 children and 4 staff at the time of the visit.
On 6/05/2023 at 1:31p.m. LPA Whitmore initiated the complaint investigation and met with the Licensee Marian Ratnayake. LPA toured the facility indoors and outdoors, observing proper teacher/child ratios with 13 total children in care and 5 Teachers. LPA observed the children and teachers in each classroom. Infant Room1-8 children and 3 teachers. Infant Room 2- 5 children and 2 teachers. LPA obtained the following documents, Roster, Sign in Sheets, and Timecards, Personnel Report.
The Department conducted a full investigation, which included staff interviews, interviews with relevant parties, as well as a record review including documentation as related to the allegations. LPA did not observe, nor was information provided via interviews that provided sufficient evidence to substantiate the allegation infants in care are left unattended by facility staff, unqualified staff are left alone to provide care and supervision to infants in care, Staff do not follow proper reporting requirements. Although the allegations may have happened or are valid there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are deemed unsubstantiated. An exit interview was conducted, a copy of this report, appeal rights along with Notice of Site Visit was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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