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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371289
Report Date: 08/17/2023
Date Signed: 08/21/2023 04:50:30 PM

Document Has Been Signed on 08/21/2023 04:50 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:LITTLE THINKERS MONTESSORI ACADEMYFACILITY NUMBER:
304371289
ADMINISTRATOR:KALUGAMPITIYA, LILAMANIFACILITY TYPE:
850
ADDRESS:34240 CAMINO CAPISTRANOTELEPHONE:
(949) 488-7939
CITY:CAPISTRANO BEACHSTATE: CAZIP CODE:
92624
CAPACITY: 65TOTAL ENROLLED CHILDREN: 65CENSUS: 14DATE:
08/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:KALUGAMPITIYA, LILAMANITIME COMPLETED:
12:00 PM
NARRATIVE
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A case management visit was conducted today 8/17/2023 by LPA A Bootorabi. LPA toured the facility and collected census in each classroom.
The census on today's visit was as followed:
Pre-k & Toddlers 2 was combined with 14 children and 2 teachers. Later toddler option had 2 children and 1 staff.

Upon arrival the LPA observed 2 teachers in the playground. There were approximately 10 children sitting on the ground observing a car wash being conducted on the driveway of the school's property. Children were observed to put their legs outside the gate through the bars of the gate. Teachers were not observed to be at a close distant. A consultation was provided to the director.

LPA entered the facility and was greeted by the director Lililamani K. The LPA stated the purpose of the visit. The tour began and LPA observed 1 teacher with 14 children in the preschool playground.

Infant room and toddler option were observed during facility tour.

LPA requested a completed teacher file for all staff present and volunteer observed on 07/26/2023. Director stated that she did not have a complete file for the volunteer. A consultation was provide

LPA began reviewing teacher files at 10 am and ended at 11:20 am

The LPA consulted on commingle toddler option with preschool children with director.
1 toddler option child was observed in the TODDLER 2 Class that is specified for preschool classroom and 1 toddler option enrolled child was observed in the infant room. A consultation was provided.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 08/21/2023 04:50 PM - It Cannot Be Edited


Created By: Araceli Bootorabi On 08/17/2023 at 11:22 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LITTLE THINKERS MONTESSORI ACADEMY
FACILITY NUMBER: 304371289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/17/2023
Section Cited
CCR
101216.3(a)

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101216.3(a)There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance... Based on LPAs observation during facility tour, the licensee did not comply with the section
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The director stated she will be working on scheduling teachers to come earlier to avoid ratio issues in the future.
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 cited above by means of having one adult supervising 14 children in the playground... which poses a potential health and safety risk to children in care.
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Type B
08/17/2023
Section Cited
101238(a)

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101238(a)The child care center shall be clean, safe, sanitary and in good repair at all times. Based on observation , the licensee did not comply with the section cited aboveb by means of having a large
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The licensee stated that he would be moving the shed from the playground today.
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boxed item (shed) int he preschool playground during hours of operation which poses an immediate health and safety 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:Patricia Magana
LICENSING EVALUATOR NAME:Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


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Document Has Been Signed on 08/21/2023 04:50 PM - It Cannot Be Edited


Created By: Araceli Bootorabi On 08/17/2023 at 11:43 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LITTLE THINKERS MONTESSORI ACADEMY
FACILITY NUMBER: 304371289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/17/2023
Section Cited
HSC
1596.8662(b)(1)

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Effective January 1, 2018, all staff of Child Care Centers and Family Child Care Homes are required to complete the Mandated Reporter Training. New staff have 90 days to complete the training. The training must be renewed every 2 years.
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The director stated she would have the individual complete mandated reporter this week. The director stated that she would send the certificate to LPA by the end of the month.
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Based on record review, the licensee did not comply with the section cited above in by means of not having a certificated of complettion for staff working directly with children which poses a potential health and safety risk to children in care.
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Type B
08/17/2023
Section Cited
HSC1596.7995(a)(1)

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1596.7995(a)(1)....person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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The director stated she will make sure everyone has their immunization record in file by the end of the month. The director will provide a statement of completion via email to LPA as proof of correcrtion by Aug 31, 2023
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Based on LPAs interview and record review, the licensee did not comply with the section cited above by means of not having immunization records in some staff files or file for volunteer observed on 8/14/2023 which poses an immediate health and safety rights 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:Patricia Magana
LICENSING EVALUATOR NAME:Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


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Document Has Been Signed on 08/21/2023 04:50 PM - It Cannot Be Edited


Created By: Araceli Bootorabi On 08/17/2023 at 11:57 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LITTLE THINKERS MONTESSORI ACADEMY
FACILITY NUMBER: 304371289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/17/2023
Section Cited
CCR
101217(a)

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(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: Based on interview with director and record review the licensee did not comply with the
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The director stated she would have a file for the volunteer and provide a statement via email to the LPA by the end of the month.
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section cited above by means of not having a volunteer file or complete files for staff
which poses an immediate health and safety 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:Patricia Magana
LICENSING EVALUATOR NAME:Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: LITTLE THINKERS MONTESSORI ACADEMY
FACILITY NUMBER: 304371289
VISIT DATE: 08/17/2023
NARRATIVE
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The LPA requested to review staff records of adults working directly with children. The following documents were requested for review exemptions or exemptions, Staff Qualifications, Immunization Records, LIC 9052 Employee Rights, LIC 9108 Statement Acknowledging Requirement to report Child Abuse, 1 CPR First Aid Certification of staff present at the facility at all times, TB clearance, and a Mandated Reporter Training Certificate.
The facility had one separate file for each staff member. The files reviewed during today’s visit were observed to be incomplete. A consultation was provided on documents observed to not be completed in file. And a consultation on submitting waivers.

LPA observed toddler option children co-mingled in the yard with infants. 2 toddler option children were with infants in the playground. Then 1 toddler option child was sent to infant room and other toddler option child was sent to preschool classroom. LPS consulted on the matter with director earlier on the tour and then LPA observed toddler option child in preschool classroom. LPA consulted once more regarding toddler option enrolled children being in toddler option room only. During the exit interview the LPA consulted on this matter once more.

LPA discussed TSP and director accepted.

The facility did not meet the California Code of Regulations, Title 22 Division 12, and regulations not met were observed, discussed, and cited at the time of the visit.

The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today: CCR 101216.3(a), CCR 101238(a) HSC 1596.8662(b)(1) HSC 1596.7995(a)(1), and CCR101217(a)
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 08/21/2023 04:50 PM - It Cannot Be Edited


Created By: Araceli Bootorabi On 08/17/2023 at 01:35 PM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LITTLE THINKERS MONTESSORI ACADEMY
FACILITY NUMBER: 304371289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/17/2023
Section Cited
CCR
101216.4(a)(1)

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101216.4(a)(1) Preschool Program with Toddler Component:No child in the toddler program shall be placed in the preschool program before the age of 30 months without written permission from the child's authorized representative.Based on observation, director interview
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The director stated she will no longer comingle and will have a staff member in that class.
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 and record review, the licensee did not comply with the section cited above by means of not having written permission and comingling children with preschool classrooms and infant which poses an immediate health and safety 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:Patricia Magana
LICENSING EVALUATOR NAME:Araceli Bootorabi
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


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