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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371290
Report Date: 06/20/2024
Date Signed: 06/20/2024 11:57:05 AM

Document Has Been Signed on 06/20/2024 11:57 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:LITTLE THINKERS MONTESSORI ACADEMYFACILITY NUMBER:
304371290
ADMINISTRATOR/
DIRECTOR:
KALUGAMPITIYA, LILAMANIFACILITY TYPE:
830
ADDRESS:34240 CAMINO CAPISTRANOTELEPHONE:
(949) 488-7939
CITY:CAPISTRANO BEACHSTATE: CAZIP CODE:
92624
CAPACITY: 7TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
06/20/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Director Lilamani KalugampitiyaTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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On 6/20/2024, Licensing Program Analyst (LPA) Chan conducted a Legal/Non-Compliance inspection. LPA met with Director Lilamani Kalugampitiya. Upon arrival the director was informed of the reason for the visit. Census was taken; 4 infant children were being supervised by one qualified teacher. An on-site Facility Personnel Report Summary review showed that all facility staff or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions.

Children’s Records: 3 Infant records were reviewed, and there was a separate, complete, and current record for each child. In the areas reviewed, infant files do have LIC9227 or Individual Infant Sleeping Plan and Infant Needs and Services Plan is up to date. There is also a complete record of the 15-minute Infant safe sleep log of the 3 records reviewed during today’s inspection, which is found to be within compliance.

Administration of Child Care Licensing: 1 Staff file was reviewed for staff present during the facility inspection on this date. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1596.7995 (a)(1) a 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.

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporter training, and to renew the training every two years.

Infant Car e Food Service: LPA inspected and observed the feeding bottles and containers for infants were properly labeled.




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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: LITTLE THINKERS MONTESSORI ACADEMY
FACILITY NUMBER: 304371290
VISIT DATE: 06/20/2024
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Infant Care Activities: LPA observed 2 infants sleeping on their stomach and Needs and Services Plan were reviewed and within compliance. None of the infants were swaddled.

Infant Care Center Sleeping Equipment: LPA observed crib sheets were fitted sheets.

Infant Care Fixtures, Furniture, Equipment: LPA observed changing table is within arm’s reach of a sink.

Receipts of Licensing Reports LIC 9224: The facility will keep the LIC9224 for all licensing reports that require a receipt. The receipts were checked in the children's files during the visit; the facility is within compliance.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Appeal Rights and report were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and the report was reviewed with the director.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC809 (FAS) - (06/04)
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