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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300275
Report Date: 08/09/2022
Date Signed: 08/09/2022 03:11:56 PM

Document Has Been Signed on 08/09/2022 03:11 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GALLAGE FAMILY CHILD CAREFACILITY NUMBER:
336300275
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
08/09/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:19 PM
MET WITH:Janitha GallageTIME COMPLETED:
03:15 PM
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On 8/9/22 at 02:19pm, Licensing Program Analyst (LPA) Jeanette Sanchez arrived at the facility to conduct a case management inspection to increase capacity to a large family childcare home. Present during this inspection were: licensee Janitha Gallage and spouse/assistant.
Fire Clearance was approved by Lake Elsinore Fire Department on 8/2/22.

Updates to LIC279 include:
Normal days/hours of operation Mon-Fri 6am-6pm. Ages served 6 months-12 yrs old.

Off-limit areas include: All upstairs, kitchen, dining room and garage

At 2:35pm, LPA toured the facility, inside and out with licensee and the following was observed and/or discussed: LPA provided infant safe sleep regulation information, including LIC9227 and sleep log (up to 24 months) guidance.


An annual inspection was completed on 2/16/22, at which time no deficiencies were found. No deficiencies observed during time of this inspection.

The application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification after:

1. Off-limit kitchen/dining room is made inaccessible

Exit interview conducted and this report along with the appeal rights were reviewed and provided to licensee Janitha Gallage. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2022
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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