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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300576
Report Date: 11/22/2022
Date Signed: 11/22/2022 01:51:53 PM

Document Has Been Signed on 11/22/2022 01:51 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:BRIGHT MINDS MONTESSORI,INC.FACILITY NUMBER:
336300576
ADMINISTRATOR:DE SILVA, CHAMALIFACILITY TYPE:
840
ADDRESS:17159 GRAND AVENUETELEPHONE:
(951) 378-4103
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
11/22/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Nam and Chamali De SilvaTIME COMPLETED:
02:20 PM
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Licensing Program Analysts (LPAs), Ana Noble and Lorena Valenzuela conducted a pre-licensing inspection this date for a proposed Infant Program. The days and hours of operation will be: Monday-Friday 6:00 am to 6:30 pm. LPAs met with Nam De Silva, Applicant and Chamali De Silva, Director who led a tour of the facility at 9:45 AM. This is a combination center with Infant and School Age Programs.

The facility was toured inside and out, and the following was observed:
· Classrooms are NOT adequately equipped with age and size appropriate furniture and equipment. Classroom has not yet been set up with the equipment.
· Water dispenser and disposable cups, supply drinking water in the indoor activity space
· Playground is enclosed by a wrought iron fence.
· Outdoor activity area is supplied with age and size appropriate equipment.
· There are no accessible bodies of water present. If wading pools or similar products are used, they must be emptied immediately after use and stored in an upright position.
· There isn't adequate amount of cushioning material - sand in place under play equipment
· Adequate shade will be provided by easy ups.
· Drinking water is provided in the outdoor play area by water dispenser and disposable cups.
· Food preparation area is NOT set up with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies
· The office area is located main building near the entrance
· Staff room will serve as the isolation area for ill children temporarily until parents arrive
· There is a working telephone located in the facility.
· Medication will be stored in the main building in a locked cabinet which is inaccessible to children
· Storage area for toxins and poisons is locked, located in storage closet outside office/main building.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.
FACILITY NUMBER: 336300576
VISIT DATE: 11/22/2022
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· Medication administration forms were reviewed
· First Aid kit was not available during this visit.
· Sign in/Sign out record was reviewed and meets regulation requirements
· Parent Board located entrance of the office with all required forms.
· Carbon Monoxide Detector located in each building and were test and operable.

Measurements were taken and the following was determined:

School Age Indoor Activity Areas-
LPA has determined that there is sufficient space to accommodate 12 children in Building #3.

School-age Bathroom Fixtures
4 toilets x 15 = 60 children
4 sinks x 15 = 60 children

School Age Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 42 children.

Limiting factor for school age is requested capacity. The Fire Clearance granted on 11/8/2022.
School Age capacity is limited to 12 children.

During the inspection, the following was reviewed with Facility Representative, Nam De Silva:
· Component II Orientation was completed
· The applicant was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The importance of checking for recalled infant (children) devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant (children) devices with the CPSC to be notified of any recalls on their purchased equipment.

· Provider Information Notice (PIN) 22-20-CCP: Resources and Requirements on Lead Testing in Child Care

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.
FACILITY NUMBER: 336300576
VISIT DATE: 11/22/2022
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· LPA reviewed Incidental Medical Services (IMS). For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department if the facility will provide the services. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
· The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A review of staff records on 11/15/2022 indicates that the applicant and/or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions. The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA discussed the safe sleep regulations with facility representative, Nam and Chamali De Silva, Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with Facility representative the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.
FACILITY NUMBER: 336300576
VISIT DATE: 11/22/2022
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.


The following items need to be completed/corrected prior to a license being issued:

1. Clean and sanitize entire facility (all classrooms, including window, bathrooms ), repair baseboards where needed. Follow up inspection will be scheduled and conducted once all plan of corrections are completed.
3. Set up classrooms with all equipment.
4. Replaced damaged ceiling tiles inside classrooms.
5. Replace or repair broken outdoor play equipment and repair cracks in cushioning material.
6. Set up outdoor shade structure.
7. Clear weeds and add additional cushioning material (sand) to outdoor playground.

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 12_children/infants?_. As agreed upon by facility representative, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied.

If all corrections are approved and facility licensed, you must have the drinking water outlets used for drinking and cooking tested for lead and post the results within 180 days of licensure.

Exit interview conducted and report was reviewed with Facility representative Nam De Silva.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
LIC809 (FAS) - (06/04)
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