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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300577
Report Date: 11/04/2024
Date Signed: 11/04/2024 04:23:13 PM

Document Has Been Signed on 11/04/2024 04:23 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BRIGHT MINDS MONTESSORI,INC.FACILITY NUMBER:
336300577
ADMINISTRATOR/
DIRECTOR:		LESLIE MARQUEZFACILITY TYPE:
830
ADDRESS:17159 GRAND AVENUETELEPHONE:
(951) 378-4103
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: DATE:
11/04/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Nam De Silva OwnerTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On the above noted date and time Licensing Program Analyst (LPA's) Griselda Castellon and Diana Brasel were conducted a pending increase visit for the infant and toddler option program. During the tour of the facility an Infant Safe Sleep violation was observed;

LPA's observed 4 cribs two of the cribs did not have fitted sheets with one child in one of the cribs without a fitted sheet. LPA's observed the one child napping on a loose blanket underneath them, with a blanket over the child's body, a pacifier in the child's mouth, with an attached pacifier clip.

See LIC 809D for cited deficiency:

An exit interview was conducted, and this report was reviewed with the owner Nam De Silva.
Appeal rights were discussed and provided during the exit interview.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Griselda Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2024
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 11/04/2024 04:23 PM - It Cannot Be Edited


Created By: Griselda Castellon On 11/04/2024 at 02:54 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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.
FACILITY NUMBER: 336300577

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/05/2024
Section Cited
CCR
101439.1(1)(f)

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Infant Care Center Sleeping: (1) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. (f) Cribs shall be free from all loose articles and objects, including
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The licensee has agreed to place fitted sheets on the crib mattresses. The licensee has stated, he will conduct a training with staff specifically in regards to Infant Safe Sleep, a memo will be provided to staff no later 11/05/2024.
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blankets and pillows. This requirement is not met as evidenced by LPA's observation, the licensee did not comply with the section cited above. LPA's observed a child napping in a crib without a fitted sheet, the child was laying on a loose blanket, with a blanket over the childs body.
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The correction for the crib sheets was done at time of visit.

Proof of memo will be provided no later than close of business on 11/05/2024, along with a signed copy of the memo by staff within 10 business days.
Type B
11/05/2024
Section Cited
CCR101439.1(1)(A)

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Infant Care Center Sleeping; (1) Pacifiers shall be allowed in the crib if the following provisions are in place: (A) There shall not be anything attached to the pacifier. This requirement is not met as evidenced by LPA's observation, the licensee did not comply with the section cited above.
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The licensee has stated, he will conduct a training with staff speficic to Infant Safe Sleep regulations. The licensee has stated, a memo will be provided to staff regarding this regulation no later than 11/05/2024.

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LPA's observed a child napping in a crib with a pacifier in their mouth with an attached pacifier clip.
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Proof of memo will be provided no later than close of business on 11/05/2024, along with a signed copy of the memo by staff within 10 business days.
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:Monica Cuddy
LICENSING EVALUATOR NAME:Griselda Castellon
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2024


LIC809 (FAS) - (06/04)
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