198019383-6-29-2022-33-CC-NTCG-CFUT28-20220629142019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019383
Report Date: 06/29/2022
Date Signed: 06/29/2022 02:20:32 PM

Document Has Been Signed on 06/29/2022 02:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	WARNAPURAGE, WATHUTHANTRIGE & CHANDRASENA FCCH		FACILITY NUMBER:	198019383
ADMINISTRATOR:	WARNAPURAGE WATHUTHANTRIGE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 641-8047
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91006
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 7	DATE:	06/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:29 PM
MET WITH:	Piyumi Warnapurage - Co-licensee		TIME COMPLETED:	02:38 PM

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced annual random inspection to the above facility. At 12:29pm, LPA met with licensee, Piyumi Warnapurage. Also present during this inspection is, Co-licensee Kanchana Chandrasena. The licensee states that she currently has 10 children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 7am-6pm, Monday-Friday.

This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, front living room (classroom), back living room, front yard and backyard (fenced). The children use the bathroom attached to the front living room. Per licensee, areas off limits to children and parents include: all bedrooms, back restroom, front yard, and back portion of backyard, separated by fencing. The licensee provides food for children in care.

The licensee states that 5 adults and 1 minor currently live in the home. All persons living in the home are identified on the attached LIC811. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

PHYSICAL PLANT

At 12:40pm, LPA was lead on a tour of the facility by the licensee. Upon entry into the home, the first room entered is the front living room which is referred to as the "classroom" for the facility. There is a section that has been completely sealed to make a fireplace inaccessible to the children in care. There are plenty of age appropriate toys, equipment, and books available for children to use. At 12:43pm, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/30/2022, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.
REPORT CONTINUES PAGE 1 of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WARNAPURAGE, WATHUTHANTRIGE & CHANDRASENA FCCH	FACILITY NUMBER: 198019383
	VISIT DATE: 06/29/2022

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Per licensee, the front living room will be used as an area for an ill child until an authorized representative comes to pick up child. Adjacent to the front living room is a small doorway to a bathroom for the children in care to use. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children, by being placed in a tall cabinet with a latch that is out of reach of the age of children being served. Bathroom was clean and free of hazards. The tour continued through the kitchen. Cabinets and drawers in the kitchen have child safety locks and latches to prevent children from opening them. Sharp knives are kept in the cabinet underneath the sink and are made inaccessible with a child safety lock. The dining area is next to the kitchen with age appropriate seats and table. The last room available to the children is the back living room which is used as a napping area and activity space. Most of the activities taking place at the facility occur in the back living room due to the summer weather. During the inspection, LPA observed the children napping on cots in the back living room. Smoke and carbon monoxide detectors were tested and are operable. The licensee states that there is a land line on the premises. There are first aid supplies available.

At 12:50pm, LPA observed the back yard area. The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. There is grass available for children to play on. There is fencing all around, a swing set, small slides, ridable carts, and age appropriate toys and equipment. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2023. Licensee and other personnel have complete mandated reporter training that expires on 02/23/2024. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information speciﬁed by regulation.

The following was discussed: -Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately.

-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home. REPORT CONTINUES PAGE 2 of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WARNAPURAGE, WATHUTHANTRIGE & CHANDRASENA FCCH	FACILITY NUMBER: 198019383
	VISIT DATE: 06/29/2022

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Infant Care: Licensee states that they are currently caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. Licensee states that infants sleep in the back living room. LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices. PIN 20-24-CCP was provided and explained during the inspection.

Incidental Medical Services (IMS):

The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

REPORT CONTINUES PAGE 3 of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WARNAPURAGE, WATHUTHANTRIGE & CHANDRASENA FCCH	FACILITY NUMBER: 198019383
	VISIT DATE: 06/29/2022

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At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative.

Exit interview was conducted with Licensee Piyumi Warnapurage, at 2:20pm, copy of report provided.

END OF REPORT PAGE 4 of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

LIC809 (FAS) - (06/04)

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