197700452-3-13-2026-12-CC-EGAA-DS5PVX-20260313113952

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700452
Report Date: 03/13/2026
Date Signed: 03/13/2026 11:40:17 AM

Document Has Been Signed on 03/13/2026 11:40 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:	ARAMBEGAMA FAMILY CHILD CARE		FACILITY NUMBER:	197700452
ADMINISTRATOR/ DIRECTOR:	PRASANNA YAMASINGHEGE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 200-5320
CITY:	SAN FERNANDO	STATE: CA	ZIP CODE:	91340
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	03/13/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Arambegama P. Arambagama, Licensee		TIME VISIT/ INSPECTION COMPLETED:	11:50 AM

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 Friday, March 13, 2026, Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced annual inspection and met with Licnesee Aramebegama, who guided LPA Garcia on a tour of the facility. There were a total of 8 children present (2 infants, 4 preschool aged, 2 school aged). Family members residing in the home have been discussed with licensee. Operating hours are Monday to Friday from 6:30 a.m. to 5:30 p.m. and care for children ages 0 to 13 years old. This facility is a two-story home that consists of 4 bedrooms, 2 1/2 bathrooms, kitchen, living room, laundry room, attached garage and backyard fenced. Areas off limits to children include- All second floor, 4 bedrooms, 2 bathrooms, kitchen, garage, and front yard. Areas accessible to children include the Living room and dining room (daycare area) and ½ bathroom located on the right of the home. LPA Garcia inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA Garcia observed central AC and the vents located on the ceiling. LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA did not observe a fireplace nor a wall heater. LPA observed 2 pack and play cribs and observed 1 infant sleeping on his stomach. LPA Garcia asked licensee if the child had a medical exemption to sleep on his stomach and licensee stated she did not. LPA Garcia informed licensee that she must immediately turn the child to sleep on his back, licensee agreed. LPA gave licensee safe sleep handouts and explained importance of following the safe sleep regulations. LPA observed an infant in care being placed in a item that is prohibited LPA Garcia observed cleaning compounds items on bottom of kitchen sink cabinet with a childproof lock making it inaccessible for children to open. For water drinking, licensee stated she provides water bottles. The licensee stated the facility provides a.m. snack, lunch and p.m. snacks. LPA informed licensee that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: ARAMBEGAMA FAMILY CHILD CARE	FACILITY NUMBER: 197700452
	VISIT DATE: 03/13/2026

NARRATIVE

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Licensee stated she currently does not have any children with severe food allergies nor on medication.
LPA Garcia entered the bathroom and observed the toilet, hand washing sink, hand soap and there is no cabinet in the bathroom and did not observe hazard materials and observed the restroom to be in good condition.
LPA Garcia asked the licensee if there were any pets, poisons, firearms, weapons, or bodies of water. The licensee stated she has no pets, no poisons and no bodies of water, no firearms, and no weapons. LPA did not observe pets, poisons, firearms, weapons, nor bodies of water. The license was informed that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.

LPA Garcia observed the required 2A10BC fire extinguisher located in the daycare room and the valve on the green area indicating fully charged. Licensee was not able to provide purchase receipt but stated she purchased a year ago. LPA informed her that fire extinguishers are required to be serviced or replaced annually. LPA observed carbon monoxide detector and smoke alarm located near the kitchen. LPA tested the carbon monoxide and smoke alarm. LPA Garcia heard the sounds and are operable. However LPA Garcia later heard the smoke alarm continually beeping and informed licensee batteries needed to be replaced. LPA observed the first aid kit to missing band aids, but did observe , gauzes, and antiseptic wipes and located in hallway cabinet. For ill isolation, licensee stated she utilize a corner of the daycare room. Last drill conducted 2/10/26.

LPA Garcia inspected the play outdoor (backyard) area that is utilized by children for safety, comfort, and cleanliness. LPA observed the backyard to be fenced and gates closed and with a keypad lock. LPA observed the play equipment to be age appropriate and in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space (artificial turf) is maintained in a safe condition and is free of hazards. For outdoor water drinking, children bring out their water bottles. Air conditioning unit is barricaded and inaccessible to the children.
LPA Garcia observed licensee Pediatric First Aid/ CPR certification dated 10/27/24 and Health and Safety certification dated 8/26/2020, and licensee was not able to provided proof of immunization against Pertussis, MMR and Influenza declination. Licensee has completed the Child Abuse Mandated Reporter (AB 1207) dated 1/14/25. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

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: ARAMBEGAMA FAMILY CHILD CARE	FACILITY NUMBER: 197700452
	VISIT DATE: 03/13/2026

NARRATIVE

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LPA observed the required postings, Pub 394 Notification of Parents Rights, however facility sketch was not observed. LPA also, reviewed children roster, children files and staff files. LPA observed the children’s filed reviewed did not have LIC 995, Safe Sleep Log Plan for infant observed in care.
The following was also discussed with the licensee:

1. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

2. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

4. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated.

5. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.
6. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

7. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.
8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.
9. Smoking is prohibited in the family childcare home.

10. Children and staff records must be maintained and updated as needed and be available for review by the Department.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

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: ARAMBEGAMA FAMILY CHILD CARE	FACILITY NUMBER: 197700452
	VISIT DATE: 03/13/2026

NARRATIVE

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11. Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

12. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

13. The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

14. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

15. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

16. Dog(s) and/or pets are recommended to be isolated from children in care.

17. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
Licensee was reminded that all adults 18 and over living or working in the home, 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.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

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: ARAMBEGAMA FAMILY CHILD CARE	FACILITY NUMBER: 197700452
	VISIT DATE: 03/13/2026

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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.
LPA discussed the safe sleep regulations with Licensee 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 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.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
Licensee was informed of the MyChildCarePlan.org website; 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.

Corrections Needed: 1) Fire extinguisher needs to be replaced and purchase receipt provided to LPA 2) Licensee will submit assistants immunization record to LPA and keep a copy on file. 3) Add band Aids or adhesive bandages to first aide kit. 4) provide lease agreement to LPA and keep on file in facility. 5) Infants parents will fill out safe sleep plan and a will be submitted to LPA. 6) batteries will be replaced in smoke alarm. 7) LIC 995 will be signed by parents and portion placed in the child’s file. 8) Emergency Disaster plan to be posted on license board and provide copy to LPA.

During this visit, two Type B deficiencies are being issued today for regulations not followed, see LIC 809-D for more information.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee, Arambegama P. Arambegama.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/13/2026 11:40 AM - It Cannot Be Edited

Created By: Evelyn Garcia On 03/13/2026 at 11:29 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ARAMBEGAMA FAMILY CHILD CARE	FACILITY NUMBER: 197700452
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/13/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(d)(1)

Operation of A Family Child Care Home

(d) The home shall provide safe toys, play equipment and materials. (1) Fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Product Safety Commission shall not be used for children in care or accessible to children in care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed an infant to be placed in device that is prohibited from being in the day care.
	POC Due Date: 03/14/2026
	Plan of Correction
1 2 3 4	LPA notified licensee and removed the infant and placed device in the gareage. LPA gave licensee safe sleep regulation handouts and flyers. Licensee agreed to not have the device in the facility.

Type B

Section Cited

CCR

102425(j)(2)(C)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Infants up to 12 month of age who are sleeping in a position other than on their back. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed infant asleep on stomach upon entering facility.
	POC Due Date: 03/14/2026
	Plan of Correction
1 2 3 4	Licensee was given safe sleep plan, safe sleep regulations hand out and flyers and agreed to read the regulations to stay informed. Licensee will submit Safe Sleep Plan to LPA.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Mariela Ramon
NAME OF LICENSING PROGRAM MANAGER:

	Evelyn Garcia
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

LIC809 (FAS) - (06/04)

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