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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495420
Report Date: 07/02/2024
Date Signed: 07/03/2024 09:56:21 AM

Document Has Been Signed on 07/03/2024 09:56 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:DALUWATTA FAMILY CHILD CAREFACILITY NUMBER:
197495420
ADMINISTRATOR/
DIRECTOR:		CHAMPA DALUWATTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 703-2030
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/02/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Champa DaluwattaTIME VISIT/
INSPECTION COMPLETED:
03:20 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
On 07/02/2024 at 09:00 a.m., Licensing Program Analyst (LPA) Cristina Castellanos conducted an announced Pre-licensing Inspection and met with Applicant, Champa Daluwatta. Present during today’s inspection was Applicant Champa Daluwatta, applicant’s partner S. Desilva and applicant’s two minor children. LPA disclosed the purpose of the inspection and was granted entry into the home by the applicant. The purpose of this inspection is to ensure that health, safety and personal rights as required by Title 22 Regulations governing California Child Care Homes will be met by the applicant. This is an application for a large family child care home and the facility plans to operate between the hours of 06:30 a.m. - 6:00 p.m., Monday - Friday.

Per facility sketch and tour of the home, the following was observed and discussed with the Applicant during the inspection:

The home is a single-family home, consisting of 3 bedrooms, 2 bathrooms, a living room, a kitchen, a dining area, and a detached garage.

Applicant confirmed that the areas that are inaccessible (OFF LIMITS) to children are all 3 bedrooms, bathroom no. 2, the kitchen/laundry area, the side passage next to the home (right side) which is the bunny’s designated area, the detached garage and the back passage behind the garage which is the birds’ designated area, who are also contained inside a large bird cage. LPA observed the pets’ designated areas to have secure gates. LPA reminded licensee to ensure the gates to the pet areas are always closed and locked. Furthermore, LPA reminded licensee that any area designated as OFF LIMITS should be made inaccessible during the hours of operation and/or while children are present.



Continue
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALUWATTA FAMILY CHILD CARE
FACILITY NUMBER: 197495420
VISIT DATE: 07/02/2024
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
Families will enter the home through the main entrance where they will be led to the main living room. The living room and dining room area were observed and inspected. Per applicant the living room will be the designated day care space. The living room was observed to have two small children tables with chairs, a play yard, two 8-cube shelf units, a bookshelf organizer, six cots, a 5-compartment storage cabinet, a fireplace and a small side table. The dining area was observed to have a dining table with 4 chairs, one highchair, a 5-compartment storage cabinet, and a woven wood hamper. Additionally, LPA observed a changing table next to the children’s designated bathroom. Applicant confirmed children will occasionally nap in the living and dining space. Per applicant the children will eat in the living room.

LPA observed safety gates at the entrance of the kitchen as well as the hallway leading to all bedrooms. Additionally, LPA observed all bedroom doors to be locked. Moreover, to access the backyard the children will have to use the back sliding door in the living room.

Applicant confirmed the home will be providing meals and snacks. LPA discussed the importance of having procedures in place to work with allergies and/or dietary restriction. LPA encouraged applicant to contact their local Resource and Referral agency to inquiry about any food programs in the area and any other resource. LPA observed and inspected all kitchen cabinets and counter space. LPA observed cabinets to have a safety latch and sliding cabinet locks. All sharp objects and knives were observed to be inside a top cabinet with a safety latch and sliding cabinet lock. All cleaning compounds were observed to be stored in a top cabinet with a safety latch and a sliding cabinet lock above the washer and dryer, located in the laundry room, making all contents inaccessible to children.

The following was also observed by LPA during inspection:
§ All adults living in the home and assistant and/or substitute care providers have submitted fingerprints and child abuse index check forms to Department of Justice and received a California clearance or exemption.
§ Home is neat and clean.
§ The fireplace in the living room has an internal mesh screen curtain which is screened by bifold glass doors that have a small chain and lock. Additionally, the fireplace is barricaded by a bookshelf, preventing any access by children.
Page 2
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALUWATTA FAMILY CHILD CARE
FACILITY NUMBER: 197495420
VISIT DATE: 07/02/2024
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
§ Home has a brand new fully charged fire extinguisher, which is a 2A:10BC located at by the back entrance door between the dining area and the living room. Furthermore, the home has a Pull Fire Alarm system next to the fire extinguisher.
§ Home has a dual smoke alarm and a carbon monoxide detector.
§ Home has a working telephone.
§ All poisons are locked.
§ Hazardous materials are kept out of the reach of children (inaccessible):
Kitchen: all sharp utensils and cutlery, cleaning supplies, medicines, drawers and cabinets with liquor, plastic bags, and sharp things or small things children can swallow, etc.
Bathroom: shampoo, mouthwash, toothpaste, medicines, perfumes/lotions/cosmetics, solvents, etc.
Garage and Outdoors: solvents, gasoline, oil, turpentine, paint, sharp tools, lawnmower, gardening
tools, poisonous plants, abandoned machinery, old refrigerators/freezers, old vehicles, etc.
§ According to the Applicant, there are no firearms or weapons in the home. None were observed by the LPA during inspection.
§ Outdoor play area is fenced all around.
§ Home does not have a swimming pool, spa, hot tub, fishpond, or any other bodies of water.
§ Toys and playthings are safe, clean, and appropriate for the age of the children.
§ Babywalkers, bouncers, jumpers, and similar items will not be used for children in care and are kept inaccessible.

During today’s pre-licensing inspection there were no corrections need to be made before licensure. Applicant was notified that the licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
Page 3
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALUWATTA FAMILY CHILD CARE
FACILITY NUMBER: 197495420
VISIT DATE: 07/02/2024
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
Applicant rents/leases the home and has landlord consent:
Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Applicant will wait until facility opens to determine IMS needs:
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA provided and reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Furthermore, the Entrance Checklist, the Capacity Regulations for a FCCH and the Prohibited Items in a FCCH flyer was provided to the applicant.

Safe Sleep


LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed applicant 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.

Megan’s Law
On this date, 05/09/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
Page 4
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALUWATTA FAMILY CHILD CARE
FACILITY NUMBER: 197495420
VISIT DATE: 07/02/2024
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
MyChildCarePlan.org
Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Subscribe to CCLD important information
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.


Exit interview conducted and report was reviewed Applicant Champa Daluwatta.


Page 5

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5