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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400678
Report Date: 05/03/2024
Date Signed: 05/03/2024 11:01:47 AM

Document Has Been Signed on 05/03/2024 11:01 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GAMARALALAGE FAMILY CHILD CAREFACILITY NUMBER:
198400678
ADMINISTRATOR/
DIRECTOR:		CHANDRIKA GAMARALALAGEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 325-6208
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
05/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Licensee Chandrika Gamaralalage TIME VISIT/
INSPECTION COMPLETED:
11:15 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Jeanette Estrada and Jonnisha Culbert conducted a case management visit for the purpose of the increased monitoring plan as determined on the Non-Compliance Conference held on 02/22/24. LPAs informed Licensee of the reason for the visit. Licensee provided a tour of the facility. There were seven children present upon LPAs' arrival. Staff 1 was also present. Staff 1 has obtained a criminal record clearance. Facility was in compliance with capacity requirements for a large family child care home.

During today's visit LPAs observed four infants present. LPAs observed a total of five play yards in the living room at the front of the home. LPAs observed two infants in two separate play yards.
LPAs observed that play yards that were in use each had a play arch with hanging stuffed toys attached. This is a potential risk to the safety of children in care. LPA advised Licensee that There shall be no objects hanging above or attached to the side. Licensee immediately removed the play arches from the play yards and placed them in an off limits area. Three other play yards in the living room did not have anything attached. LPAs did not observe any other loose items in any of the play yards.

LPAs observed infants were being supervised by either the Licensee or Staff 1 during the visit. Licensee and Staff 1 would switch between providing care to infants and older children. LPAs reviewed children's files. During file review, LPAs observed that Child 3's file did not contain LIC 9227. Per Licensee, form was provided to parent but has not been returned. LPA advised Licensee to obtain completed and signed form from parent. LPAs observed completed sleeping logs for four infants present during inspection.
LPA also observed three toddlers present engaged in play.

California Code of Regulations, (Title 22, Division 12, Chapter 1), are being cited on the attached LIC 809 regarding the hanging items above the play yard.

Exit interview was conducted with the Licensee, Chandrika Gamaralalage. A signature was obtained for this report. Licensee was provided a copy of this report. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2024
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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Document Has Been Signed on 05/03/2024 11:01 AM - It Cannot Be Edited


Created By: Jeanette Estrada On 05/03/2024 at 10:38 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GAMARALALAGE FAMILY CHILD CARE
FACILITY NUMBER: 198400678

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/06/2024
Section Cited
CCR
102425(b)(3)

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102425(b)Cribs or play yards shall be free from all loose articles and objects. (3)There shall be no objects hanging above or attached to the side of the crib.
This requirement is not met as evidenced by:

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LPAs observed Licensee immediately removed items attached to the two play yards and placed them in an off limits area.
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Based on observation, Licensee did not comply in the section cited above. LPAs observed two play yards in use had play arches with swinging stuffed toys, attached to them. This poses a potential 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:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2024


LIC809 (FAS) - (06/04)
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