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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400678
Report Date: 02/26/2024
Date Signed: 02/26/2024 12:04:50 PM

Document Has Been Signed on 02/26/2024 12:04 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GAMARALALAGE FAMILY CHILD CAREFACILITY NUMBER:
198400678
ADMINISTRATOR:CHANDRIKA GAMARALALAGEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 325-6208
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 6DATE:
02/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Licensee Chandrika Gamaralalage TIME COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Jeanette Estrada and Ashley Calderon conducted a case management inspection at the above licensed home. LPAs met with Licensee Chandrika Gamaralalage. Licensee provided a tour of the facility. There were six children and an assistant provider present during the inspection. The facility was in compliance with capacity requirements for a large family child care home. All adults present have a valid criminal record clearance and are associated to the facility.
LPA J. Estrada advised Licensee the reason for the visit was to obtain the Licensee’s signature on the LIC 9111 Non-Compliance Conference (NCC) Summary and to provide a copy of LIC 9111 to the Licensee. The NCC was held on 2/21/24 via teleconference on Microsoft Teams. LPA reviewed the contents of the NCC Summary with the Licensee and obtained the Licensee’s signature. LPA advised Licensee that copies of the LIC 9111 Non-Compliance Conference Summary and The Acknowledgement of Receipt of Licensing Reports (LIC 9224) shall be provided to parents/guardians of children in care and newly enrolled children for the next 12 months beginning today.
During the NCC, Licensee was advised of the technical violation to be issued during today’s visit for failure to properly report the incident that occurred on 10/11/23 regarding the complaint investigation. LPA reviewed LIC 624B Unusual Incident/Injury Report-Family Child Care Home and provided a copy to the Licensee. Licensee was advised to report any unusual incidents to the regional office by the next business day. LPA provided Licensee with the Monterey Park South West UIR email: MPSWUNUSUALINCIDENTREPORTS@DSS.CA.GOV
LPA obtained licensee's signature for the NCC report and the copy of this report was provided to the licensee including copy of The Acknowledgement of Receipt of Licensing Reports(LIC 9224).
The Notice of Site Visit (LIC 9213 ) was provided to the Licensee. The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00
Exit interview was conducted with Licensee, Chandrika Gamaralalage, and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
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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