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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020804
Report Date: 06/22/2023
Date Signed: 06/22/2023 11:30:24 AM

Document Has Been Signed on 06/22/2023 11:30 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SUNNADENIYAGE FAMILY CHILD CAREFACILITY NUMBER:
198020804
ADMINISTRATOR:RUKSHANI SUNNADENIYAGEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 841-0857
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
06/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Licensee Rukshania SunnadeniyageTIME COMPLETED:
11:45 AM
NARRATIVE
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At approximately 10:00am Licensing Program Analyst's (LPAs) Mary Silva and Judy Mora conducted an unannounced case management inspection to ensure the facility was in compliance with Title 22 regulations. At the time of arrival licensing staff met with Licensee Rukshania Sunnadeniyage. The purpose of the inspection was explained. There were three adults present(Licensee, Spouse and assistant).

LPA(s) observed a total of 14 children during this visit; five of the fourteen children were infants, and no school age children were present. This placed facility out of ratio. During this visit LPA(s) obtained a copy of the facility roster.

LPA(s) informed licensee Rukshania Sunnadeniyage, that this report dated 06/22/2023 document(s) one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.



Also,LPA(s) informed the licensee Rukshania Sunnadeniyage to provide a copy of this licensing report dated 06/22/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. A copy of the LIC 9224 was provided.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted with Rukshania Sunnadeniyage. Appeal rights were reviewed with the licensee and a copy was provided.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2023
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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Document Has Been Signed on 06/22/2023 11:30 AM - It Cannot Be Edited


Created By: Mary Silva On 06/22/2023 at 10:52 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SUNNADENIYAGE FAMILY CHILD CARE
FACILITY NUMBER: 198020804

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/23/2023
Section Cited
HSC
1597.465(b)

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Large family day care homes; number of children
No more than three infants are cared for during any time when more than 12 children are being cared for.
This requirement is not met as evidence by:
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LPA(s) observed Licensee called parents of child #1 and child #2 to be picked up immediately.
Licensee will view a video on
ratio requirements and submit a statement via email to LPA, listing the changes licensee will make to ensure ratio compliance by 06/29/2023.
https://ccld.childcarevideos.org/family-child-car
e-providers
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Based on observation, the
licensee did not comply with the section cited above licensee was out of ratio, as 14 children were present, five were infants which poses an immediate health, safety or personal rights risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Mary Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 06/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2023


LIC809 (FAS) - (06/04)
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