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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198018377
Report Date: 05/25/2021
Date Signed: 05/25/2021 12:16:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/12/2021 and conducted by Evaluator Ericka Hill
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210412104635
FACILITY NAME:GURUGE DE SILVA FAMILY CHILD CAREFACILITY NUMBER:
198018377
ADMINISTRATOR:CHANDRA GURUGE DE SILVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 861-7202
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY:14CENSUS: 3DATE:
05/25/2021
UNANNOUNCEDTIME BEGAN:
10:12 AM
MET WITH:Licensee - Chandra Guruge De SilvaTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
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On 05/25/2021 at 10:12am Licensing Program Analyst (LPA) Ericka Hill called the Licensee of Guruge De Silva Family Child Care Home to deliver the complaint findings. The visit was conducted via tele-visit due to COVID-19 restrictions.

During the inspection, LPA Hill conducted interviews, reviewed records, and made observations regarding the allegation above. Interviews with parents revealed they have no concerns regarding the facility. Parents stated their children have been attending the facility for 2 years or more and that they are happy with the care provided to their children. Parents further stated that the staff communicate with the parents with any concerns or incidents that happen with the children at the facility.

{report continues on page 2 of LIC9099}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Ericka Hill
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 30-CC-20210412104635
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GURUGE DE SILVA FAMILY CHILD CARE
FACILITY NUMBER: 198018377
VISIT DATE: 05/25/2021
NARRATIVE
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LPA observed the care and supervision of the facility on 03/05/2020 and 04/13/2021. LPA observed the facility to be clean and safe for children in care. LPA observed both the Licensee and Staff #1 caring for children in age-appropriate manners and did not observe any children being injured. LPA did observe Staff #1 consoling children while conducting both the physical and virtual visit.

Although it was alleged that a child sustained unexplained injuries while in care, after further investigation it was revealed that staff communicated with the parent on multiple occasions to trim their infant child’s nails. According to the interviews from pertinent individuals, the nails were trimmed but the infant was still able to scratch themselves.

Based on the interviews, observations, and review of records conducted by LPA Hill, the allegation above was found to be Unsubstantiated. An Unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred due to a violation of Personal Rights or a Lack of Care and Supervision.



An exit interview was conducted and a copy of the LIC9099 and Notice of Site Visit was provided to the Licensee. LPA Hill informed the Licensee to read, sign, and email the LIC9099 back to LPA Hill.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Ericka Hill
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2