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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370936
Report Date: 07/19/2019
Date Signed: 07/19/2019 11:25:34 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SHINING STAR MONTESSORI PRESCHOOLFACILITY NUMBER:
304370936
ADMINISTRATOR:VITHANAGE, IRA DAYANIFACILITY TYPE:
850
ADDRESS:1239 NORTH HARBOR BLVD.TELEPHONE:
(714) 312-9493
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:60CENSUS: 16DATE:
07/19/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Ira Dayani Vithanage, DirectorTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Stacy Torrence conducted an unannounced annual/required inspection to the above facility. Upon arrival LPA met with Dayani Vithanage, Director who guided analyst on a tour of the inside and outside of the facility. Census was taken in the activity room and toddler option classroom: there were 12 preschool children being supervised by 1 staff in the activity room and 4 toddler children in their toddler classroom being supervised by 1 staff. This program operates 6:30 am- 6:30 pm, Mon-Fri, ages of children served are preschool children ages 2-6 years of age and 7 option toddler children program for ages 18-36 months. A review of criminal record clearances indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

LPA reviewed care and supervision of children, staffing ratios, health related services; including medications and first aid supplies, inaccessibility to poisons, and hazardous items that can pose a danger to children. Toilets and sinks were inspected to ensure they are safe and in a sanitary operating condition. Floors were inspected for safety and cleanliness. Equipment and furniture were inspected to ensure it's in good condition, free of sharp, loose or pointed parts. There was appropriate napping equipment available for children in care. The playground was inspected for safety, good condition of equipment, including appropriate cushioning material. There was adequate toys and equipment available for children. LPA observed all required forms posted. LPA observed posted menus and advised Director to update them to include portion sizes. This facility provides AM snack, lunch, and a PM snack. Uncontaminated drinking water was readily available both indoors and outdoors. The facility has an updated fire drill log and children’s roster. Carbon monoxide and smoke detectors were tested and are operable. Per Director, there are no weapons, firearms in the facility. LPA reviewed the sign/in-sign/out sheet. Staff's files were reviewed for education verification, CPR/First Aid, and new immunization requirements; such as, MMR, Pertussis, and Influenza vaccines, and mandated reporter training. A sample of children's files were reviewed for completeness of admission agreement, immunization records, and required licensing forms. Director was given a copy of the staff and children confidential names list.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 703-2823
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SHINING STAR MONTESSORI PRESCHOOL
FACILITY NUMBER: 304370936
VISIT DATE: 07/19/2019
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Incidental Medical Services-IMS was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.htmThe updated plan of operation has been received in our office for providing Incidental Medical Services. (IMS).

The facility representative was informed that licensing updates, regulations, and forms are located on the CCLD website: www.ccld.ca.gov . Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov

During this inspection, there was no deficiency cited per CA Code of Regulations Title 22, Division 12.



Report was reviewed and discussed. The licensee was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. The Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. This report is to be on file and accessible for public review at the facility for at least 3 years.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 703-2823
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
LIC809 (FAS) - (06/04)
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