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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020804
Report Date: 08/11/2023
Date Signed: 08/11/2023 11:57:12 AM

Document Has Been Signed on 08/11/2023 11:57 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: 7DATE:
08/11/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Licensee Rukshani SunnadeniyageTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPA) Mary Silva conducted an unannounced poc (plan of correction) inspection to insured that the Type B deficiencies cited on 07/28/2023 have been cleared. LPA met with licensee, Rukshani Sunnadeniyage who guided analysts on a tour of the facility. There were 7 children present during this inspection- 3 being infants. The following was observed:

- 2A BC10 Fire Extinguisher indicated to be fully charged and service tag date of 08/07/2023.

- AB1207 for Licensee and assistant have been completed with an expiration date of 08/2025 for licensee and expiration date of 08/2024 for assistant.

- 8 children files were reviewed and complete.

- Staff files were reviewed and complete.

- Licensee submitted a declaration stating that any absences from the facility will be reported in a timely manner to the Department and will give access to facility representative of personnel and children’s files.

LPA discussed 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-and-resources/safe-sleep as an additional resource.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CARE
FACILITY NUMBER: 198020804
VISIT DATE: 08/11/2023
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LPA cleared deficiency on this date and provided a copy of the Licensing Report to licensee. LPA issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

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 and report was reviewed with Licensee.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC809 (FAS) - (06/04)
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