198021017-9-1-2022-33-CC-CGRN-CHUV82-20220901161201

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021017
Report Date: 09/01/2022
Date Signed: 09/01/2022 04:12:33 PM

Document Has Been Signed on 09/01/2022 04:12 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:	CHILD'S WORLD		FACILITY NUMBER:	198021017
ADMINISTRATOR:	RUKMAL SAMARANAYAKA		FACILITY TYPE:	840
ADDRESS:	1027 S. SAN GABRIEL BLVD		TELEPHONE:	(909) 896-8942
CITY:	SAN GABRIEL	STATE: CA	ZIP CODE:	91792
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 15	CENSUS: 0	DATE:	09/01/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Rukmal Samaranayaka		TIME COMPLETED:	04:20 PM

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	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPAs) Crystal Green and Enjoli Maeweather to inspect and measure facility for capacity determination. Licensing staff met with Applicant, Rukmal Samaranayaka, who guided analyst on a tour of the facility. There is also a preschool program (198020674) located on the same premises. Proposed operating hours will be Monday through Friday from 2:00 PM to 6:00 PM. At 1:35 PM, Licensing staff was guided through a tour of the proposed School-Age designated areas. The proposed classrooms were observed accessible through the rear entrance of the building. Facility will have a total of 2 classrooms (classroom 1 and classroom 2). LPA observed the indoor space to be physically separate from the preschool areas. Furniture and equipment were inspected for age appropriateness and good repair. Individual storage space will be available for each child. Drinking water will be made available via a water jug and disposable cups. LPA observed the facility to have restroom accessible to the children which contains 1 toilet and 1 sink. All toilets and sinks are in safe and sanitary operating conditions. The director's office located next to the rear entrance of the facility will serve as an isolation area for an ill child and ill children will use the staff bathroom. There is a first aid kit available on site. There are smoke detectors and a carbon monoxide detector on site that meets statutory requirements. This facility will provide snacks for enrolled children. Food preparation areas were inspected for cleanliness. At 2:30 pm, Licensing staff observed the proposed outdoor activity to contain a basketball hoop and picnic table with shade canopy. Per the applicant, the school-age will only be allowed outdoor when the gate leading to the rear of the building is closed. Transportation will be provided by the facility.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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: CHILD'S WORLD	FACILITY NUMBER: 198021017
	VISIT DATE: 09/01/2022

NARRATIVE

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Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

An approved Fire Clearance has been received by the Department. Based on measurements obtained today, capacity for the school-age will be ten (10) children. LPA consulted with the applicant regarding information needed to submit a waiver request for the share usage of the restroom. LPA informed applicant that waivers are not automatically granted and will need to be review by the Regional Office for final approval. LPA obtained pictures during this inspection.

Exit interview was conducted with Applicant, Rukmal Samaranayaka.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

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