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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701115
Report Date: 11/20/2024
Date Signed: 11/20/2024 02:56:09 PM

Document Has Been Signed on 11/20/2024 02:56 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:PINK TOWER MONTESSORIFACILITY NUMBER:
376701115
ADMINISTRATOR/
DIRECTOR:		CHANDANI JAYASINGHEFACILITY TYPE:
850
ADDRESS:203 LAURINE LANETELEPHONE:
(760) 728-4754
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 36TOTAL ENROLLED CHILDREN: 20CENSUS: 15DATE:
11/20/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:13 AM
MET WITH:Devni SamaranayakeTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On 11/20/24, Licensing Program Analyst (LPA), Kelli Waters conducted an unannounced annual inspection as part of a compliance review. This is a combination childcare center, and the other licensed programs is an infant program which not inspected on this date. Director/Licensee Chandani Jayasinghe was not present and could not return for the inspection; Licensee gave verbal consent over the phone for staff member, Devni Samaranayke, to act as the facility representative. A tour of the inside and outside of the facility was granted and the following was observed and/or noted:

Facility Review:

A inspection of the facility inside and outside were conducted as part of this evaluation
• The following items were posted and updated where necessary:

- License

- Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148)

- Personal Rights (LIC613A)

- Child Car Seat Law

** Parent’s Rights Poster (PUB393) was not posted

• The facility is operating within the limits as stated on the license.

• Ratios are being met during this inspection; 15 children and 3 staff were present

• Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards

• There are no weapons present at the facility as stated by Facility Representative

• There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115
VISIT DATE: 11/20/2024
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Facility review continued:

• Drinking water is provided in the indoor activity space and in the outdoor activity space by water bottles brought from home and refilled with a filter water system.

• Medications are stored where inaccessible to children in the first aid kit in the lobby area above the filing cabinets

• Playgrounds are enclosed by appropriate fences and free of hazards

• Outdoor activity areas are supplied with age and size appropriate equipment in good condition

• All storage containers for solid waste were observed to have tight-fitting covers that are kept on, and in good repair

• Sign in/Sign out record was reviewed and meets regulation requirements

• Disaster drills are conducted at least every six months – last drill was conducted on 08/15/24

• This facility has a fire/smoke detection system, however no carbon monoxide detector was present when LPA arrived. A staff member was able to install a device while LPA was present.

• During inspection, LPA observed cleaners, mouse traps, rodent droppings, and toxic materials in areas accessible to children in Classroom 1 & 2 under and around the sink areas

• Bathrooms were observed to be safe and sanitary, LPA did observe that not all plumbing fixtures were in working order during inspection, including one faucet and one toilet.

Record Review:


A review of staff and children's records were conducted as part of this evaluation.
• Children’s records were found to be incomplete during this inspection.

• Staff records reviewed were found to be incomplete

• A staff member is present with current Pediatric CPR/First Aid which expires on 03/18/25.

• Opening and closing staff member’s CPR/First Aid expires on 03/18/25

• Director completed Health and Safety Training

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115
VISIT DATE: 11/20/2024
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Record Review continued

•LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

• A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.


To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send them email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115
VISIT DATE: 11/20/2024
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On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200

The licensee/director was asked to update the following documents, if applicable, and submit to licensing within 30 days:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made or file copy is more than 2 years old)
4.LIC 309 Administrative Organization (only if changes have been made or file copy is more than 2 years old)
5. LIC 308 Designation of Administrative Responsibility (only if changes have been made& current designation is on file)

**7 Type B deficiencies were cited during this inspection. See LIC809-D for cited deficiencies.

During the exit interview, the Facility Representative Devni Samaranayke, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

An exit interview was conducted, and this report was reviewed with the facility representative. Appeal rights were discussed and provided during the exit interview.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
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Document Has Been Signed on 11/20/2024 02:56 PM - It Cannot Be Edited


Created By: Kelli Waters On 11/20/2024 at 01:52 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: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above by having no carbon monoxoide detector in the facility, which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/20/2024
Plan of Correction
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2
3
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A staff member was able to purchase and install a carbon monoxide detector while LPA was present.
Type B
Section Cited
CCR
101218.1(c)
Admission Procedures and Parental and Authorized Representative's Rights
(c) The licensee shall post the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster in a prominent, publicly accessible area in the child care center at all times.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited aboveby not having the PUB 393 posted, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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2
3
4
Facility representative will post the PUB 393 in place of the 995A on the parent board and email photographic evidence to LPA by 11/22/24.
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:Carlos Martinez
LICENSING EVALUATOR NAME:Kelli Waters
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2024


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Document Has Been Signed on 11/20/2024 02:56 PM - It Cannot Be Edited


Created By: Kelli Waters On 11/20/2024 at 01:52 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: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239.1(c)(2)
Napping Equipment
(c) Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. (2) Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above 20 out of 20 cots with bedding in contact with other bedding, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/06/2024
Plan of Correction
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Facility representative will store bedding after each use in a space designated for each child and the bedding will not touch. Cots will be wiped down once a week or as needed and stored free of bedding. Facility representative will email photographic evidence of bedding stored and cots free of bedding and a plan of operation regarding daily bedding removal and storage practices by 12/06/24.
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in plumbing fixtures of cold water faucet in sink 1 in lobby bathroom not working and toilet 1 in classroom 1 not in working order. LPA observed lower toy shelves in classroom 1 & 2 with cobwebs and layer of dust, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/27/2024
Plan of Correction
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Facility will have faucet in lobby bathroom and toilet in classroom 1 fixed and in working order. Facility will clean all shelving of cobwebs and dust in Classroom 1 & 2. Facility will provide LPA with photographic evidence via email by 12/27/24.
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:Carlos Martinez
LICENSING EVALUATOR NAME:Kelli Waters
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2024


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Document Has Been Signed on 11/20/2024 02:56 PM - It Cannot Be Edited


Created By: Kelli Waters On 11/20/2024 at 01:52 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: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above in classrooms 2 with cleaners, toxic substances, rodent droppings, mouse traps, mops with solution next to and under sink area covered with curtain. Classroom 1 had Drano and toilet bowl cleaner under sink with a broken child lock, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/06/2024
Plan of Correction
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Facility will remove all tems from under sink in Classroom 2 and fix the child lock under the sink in classroom 1. Facility will store all cleaners, poisons, toxic items inaccessible to children. Facility will provide photographic evidence to LPA via email by 12/06/24.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in 3 out of 4 staff files reviewed did not have valid mandated reporter training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
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S1, S3 & S4 will complete the mandated reporter training for child care providers and email completed certificates to LPA by 12/20/24.
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:Carlos Martinez
LICENSING EVALUATOR NAME:Kelli Waters
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2024


LIC809 (FAS) - (06/04)
Page: 7 of 14
Document Has Been Signed on 11/20/2024 02:56 PM - It Cannot Be Edited


Created By: Kelli Waters On 11/20/2024 at 01:52 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: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101215.1(f)
Child Care Center Director Qualifications and Duties
(f) When the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher as specified in Section 101216.1(c) to act as substitute. This substitute child care center director shall be aware of center operations, including total enrollment; shall be trained in program operation; and shall be designated as an authorized person to correct operational deficiencies that constitute immediate threats to children's health and safety.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above by Director/Licnsee being out of facility for more than 30 days, starting 11/20/24 and scheduled to return 12/29/24 without a qualified substitute which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/03/2025
Plan of Correction
1
2
3
4
Licensee will review the regulation of Center Director and will write a statement of understanding that a qualified substitute must be present in absences for 30 days or more. Licensee will email signed statement to LPA by 01/03/25.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 2 out of 5 child files reviewed were missing a physician's report, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
1
2
3
4
Facility will email valid physician reports for C2 and C4 and place in child's file by 12/20/24.
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:Carlos Martinez
LICENSING EVALUATOR NAME:Kelli Waters
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2024


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