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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334841017
Report Date: 08/04/2022
Date Signed: 08/04/2022 04:49:44 PM

Document Has Been Signed on 08/04/2022 04:49 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CREATIVE BEGINNINGS MONTESSORI CENTERFACILITY NUMBER:
334841017
ADMINISTRATOR:GOONETILLEKE, ANITAFACILITY TYPE:
850
ADDRESS:332 W ALEJO ROAD #BTELEPHONE:
(760) 416-6333
CITY:PALM SPRINGSSTATE: CAZIP CODE:
92262
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: 17DATE:
08/04/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:ANITA GOONETILLEKE TIME COMPLETED:
05:00 PM
NARRATIVE
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On 08/04/22, Licensing Program Analyst (LPA) Aman Sharma and Licensing Program Manager (LPM) Kimberly Williams arrived at the facility on another matter. However, during a complaint investigation it was learned that there was a staff member working as a lead teacher from August 2021 to present without 12 Early Childhood Education units (ECE), the staff only had proof of 9 ECE units in their file.

See LIC809D for cited deficiencies in accordance with the California Code of Regulations Title 22, Division 12.

An exit interview was conducted, appeal rights discussed and a copy of this report was provided.

A copy of this report must be made available to the public, at the facility site, for 3 years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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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Document Has Been Signed on 08/04/2022 04:49 PM - It Cannot Be Edited


Created By: Aman Sharma On 08/04/2022 at 03:32 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CREATIVE BEGINNINGS MONTESSORI CENTER
FACILITY NUMBER: 334841017

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2022
Section Cited
CCR
101216.1(c)(1)

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Teacher Qualifications and Duties:
(c) To be a fully qualified teacher, a teacher shall have one of the following:
(1) Twelve post-secondary semester or equivalent quarter units in early childhood education or child development completed,...

This requirement is not met as evidenced by:
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Licenasee agrees to send proof of enrollment for staff in ECE calss: Child, Family and Community by POC due date. Licensee also agrees to use S1 as a Teachers Aide and send a written statement to licensing by Monday, 08/08/2022.
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On 08/04/2022 a file review was conducted for S1 and it was observed learned that there was a staff member working as a lead teacher from August 2021 to present without 12 Early Childhood Education units (ECE), the staff only had proof of 9 ECE units in their file.
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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:Kimberly Williams
LICENSING EVALUATOR NAME:Aman Sharma
LICENSING EVALUATOR SIGNATURE:
DATE: 08/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/04/2022


LIC809 (FAS) - (06/04)
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