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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300576
Report Date: 12/04/2023
Date Signed: 12/04/2023 12:21:58 PM

Document Has Been Signed on 12/04/2023 12:21 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:AURORA GONZALEZFACILITY TYPE:
840
ADDRESS:17159 GRAND AVENUETELEPHONE:
(951) 378-4103
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY: 12TOTAL ENROLLED CHILDREN: 4CENSUS: 0DATE:
12/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Licensee Nam De SilvaTIME COMPLETED:
12:30 PM
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On December 4, 2023 at 11:30 am Licensing Program Analyst (LPA) Jessica Rubio conducted a Case Management inspection to follow-up on the compliance plan. LPA met with Director Leslie Marquez and Licensee Nam De Silva. LPA toured the facility and took a census. There were no children present at this time. In addition, LPA reviewed staff files.

During today's tour of the facility, there was no evidence of any violation of regulations observed. No deficiencies were cited.

Exit interview conducted and report was reviewed with and provided to Licensee Nam De Silva. A notice of site visit was given and must remain posted for 30 days in location visible to all parents entering the facility. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2023
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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