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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371290
Report Date: 08/12/2025
Date Signed: 08/12/2025 03:14:37 PM

Document Has Been Signed on 08/12/2025 03:14 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 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:
08/12/2025
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Director Lilamani KalugampitiyaTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 08/12/25, at 12:50pm Licensing Program Analysts (LPAs) Anna Chan and Kathy Trinh 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 1 teachers.

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 files were reviewed, 3 of 3 files were incomplete. Infant files are missing LIC9227 or Individual Infant Sleeping Plan. There is a complete record of the 15-minute Infant safe sleep log of the 3 records reviewed during today’s inspection,

Administration of Child Care Licensing: 1 staff file reviewed.

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




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NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Anna Francesca Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 08/12/2025 03:14 PM - It Cannot Be Edited


Created By: Anna Francesca Chan On 08/12/2025 at 01:42 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: 304371290

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2025
Section Cited
CCR
101221(a)

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101221 Child's Records
(a) A separate, complete and current record for each child is maintained in the child care center.
This requirement was not met as evidenced by:
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Director stated they will provide complete documents by due date of 8/26/25.
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3 of 3 children's files were incomplete and missing documents such immunization and LIC9227

This poses a potential risk to health and safety and personal rights for children in care.
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Type B
08/26/2025
Section Cited
HSC1596.8595.(d)(1)

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1596.8595.(d)(1) A licensed child day care facility shall provide to the parents ...in the facility copies of any licensing document pertaining to a conference conducted by a local licensing agency...issues of noncompliance are discussed. This requirement was not met as evidenced by.
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The director stated the facility is to provide a statement to LPA why the LIC9224 was not provided to parents. Facility is to provide copy of LIC809 dated 03/05/24 that documents any Type A citation or Office Meeting to parents/guardians of all children currently enrolled by the next businsess day or the next day
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 Based on records reviewed and interview, The facility did not provide the 03/5/24 licensing report LIC809 and acknowledgement receipt LIC9224 to all families by the next business day.
this poses an immediate risk to the health, safety, or personal rights of children in care.
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children are in care, and to any newly enrolled parents/guardians for 12 months from the 3/5/24. Facility is to provide signed LIC9224 to LPA by8/26/25. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must also be placed in the child's file for verification.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Martha Malane
NAME OF LICENSING PROGRAM MANAGER:
Anna Francesca Chan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2025


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: 08/12/2025
NARRATIVE
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Infant Care Activities: LPAs observed 1 infant napping, 3 doing indoor activities. None of the infants were swaddled.

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

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

Receipts of Licensing Reports LIC 9224: 3 of 3 children’s file were missing signed LIC9224 dated 3/5/24.

In the areas that were evaluated, 2 Type B deficiencies were observed and in violation of the California Code of Regulations, Title 22, Division 12 at the time of the visit. 101221(a) Child’s Records and Health and Safety Code 1596.8595.(d)(1) Reports to be provided to parents or guardian of each child receiving services

Exit interview was conducted and the report and deficiencies were reviewed with Director Lilamani Kalugampitiya. A notice of site visit was given and must remain posted for 30 days. Appeal Rights were Provided.

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NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Anna Francesca Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC809 (FAS) - (06/04)
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