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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300577
Report Date: 12/30/2022
Date Signed: 12/30/2022 10:18:42 AM

Document Has Been Signed on 12/30/2022 10:18 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BRIGHT MINDS MONTESSORI,INC.FACILITY NUMBER:
336300577
ADMINISTRATOR:DE SILVA, CHAMALIFACILITY TYPE:
830
ADDRESS:17159 GRAND AVENUETELEPHONE:
(951) 378-4103
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY: 4TOTAL ENROLLED CHILDREN: 4CENSUS: 0DATE:
12/30/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:34 AM
MET WITH:Chamali and Nam De SilvaTIME COMPLETED:
10:30 AM
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On December 30, 2022 at 9:34 am Licensing Program Analyst Ana Noble arrived to conduct a plan of correction for items needing completion from Pre-licesning Inspection previously conducted on 12/19/2022. LPA met with Nam and Chamali De Silva, Licensees.

The Infant/Toddler Classrooms and playground were toured and the following items were observed to be completed:

1. Additional age appropriate indoor activities are needed for Infants children.
2. Replace stained toilets seats and place liner in all cabinets.
3. Additional outdoor equipment is needed for playground (Infant/Toddler).
4. Set up outdoor shade structure.
5. Changing table with correct size padding material.
6. Obtain high chairs for feeding.

Waiver for shared playground with Toddler Option on scheduled time basis will be processed.

The license for a total of 4 Infant and 8 Toddler will be submitted for approve once waiver has been approved and processed for a total capacity of 12 in the Infant Program.

Exit interview was conducted with Nam and Chamali De Silva and a copy of this report was provided during this visit. Must be maintained for a total of 3 year and made available to the public upon request.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 12/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/30/2022
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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