304371469-2-3-2021-06-CC-KDEI-BXVRAY-20210203115151

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371469
Report Date: 10/30/2020
Date Signed: 02/03/2021 11:52:07 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:	SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC		FACILITY NUMBER:	304371469
ADMINISTRATOR:	AMARATUNGE, HARINDRA		FACILITY TYPE:	840
ADDRESS:	1845 WEST LA PALMA		TELEPHONE:	(714) 393-2348
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	40	CENSUS: 0	DATE:	10/30/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Ms. Maria Rodriguez- Administrator		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA’s) Desai, Ketki and Torrence, Stacy conducted an on site pre-licensing inspection at this proposed School age center. LPA met with Administrators Ms. Rodriguez, Maria along with Ms. Lucero, Rubi and toured the site. The applicant has requested to provide care and supervision for School age children 6 to 12 years of age, Monday through Friday, 6.30 am. to 630 PM. in the three classrooms in the separate back area of the facility. A review of the Facility Personnel Report Summary 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. The children shall have access through the main entrance of the facility, each parent shall have a specific code to gain entrance into the facility, temperatures shall be checked along with hand sanitization, teachers shall than walk them to their classrooms. The three designated classrooms have their own entrance with enough light and ventilation. It has central cooling and heating system. Also available is a separate bathroom for Boys and Girls This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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)/ (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.htm Incidental Medication will be stored in the Director’s office in a locked cabinet and shall be administered by the teacher. Medication administration forms were reviewed. Isolation area is the Director’s office. (1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

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: SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC	FACILITY NUMBER: 304371469
	VISIT DATE: 10/30/2020

NARRATIVE

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The following were inspected in the indoor activity space:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through water dispenser in each classroom as well as individual sports bottles
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Manual sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements
· Cubbies available for storage of individual child’s personal belongings and/or bedding

Facility shall provide Breakfast / PM snacks and supper, food shall be prepared in the kitchen and shall be delivered to each classroom, during full day sessions breakfast lunch and PM snacks shall be provided.

Facility staff shall also provide Pick up and Drop off services to the surrounding schools. Facility has a 7 passenger van shall be used for transportation. Designated driver shall complete the Defensive Driving class to ensure the safety of the children.

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A)
· Menus
· Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies
· Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269) (2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

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: SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC	FACILITY NUMBER: 304371469
	VISIT DATE: 10/30/2020

NARRATIVE

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The indoor activity space was measured and is as follows:
Room # 7: 19’02” x 18’06” = 381’07” divided by 35= 10 children
Room # 8: 28’08” x 17 = 477’36 divided by 35 = 13 children
Room # 9: 22’07” x 19’01” = 419”55” divided by 35 = 12 children
( Room # 10 : is used as a storage room for now only and if changes occur, Licensing shall be notified. It is approved for use by Fire inspector.

Total space: 1277’98” divided by 35 = 36 children

2 sinks: 30 children ink
3 toilets: 45 children

School age children shall use two designated yards for outdoor activities, one is behind the Infant yard and other is being shared with the Preschool age children and safe outdoor climbing structures and equipment’s were observed. A Waiver has been requested.

Total outdoor yard: 63’08” x 45= 2650’20” divided by 75= 35 children

LPA discussed with the applicant/facility representative that all employees must have criminal record clearances associated to the facility prior to their presence in the facility, staff to child ratio requirements, direct visual supervision requirements, emergency/disaster drills, children records, mandated reporter training, and staff immunization requirements against measles, pertussis, and influenza.

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by fountain, individual sports bottles
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures and outdoor scooters
· An adequate amount of cushioning material consisting of rubber form is in place under the play structures
· Adequate shade is provided by canvas canopy on top of play structures)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

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: SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC	FACILITY NUMBER: 304371469
	VISIT DATE: 10/30/2020

NARRATIVE

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The applicant was given a pamphlet on Lead Exposure and was discussed with provider. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chaptered Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdf . Director has completed the required Health and Safety Lead Poisoning training.

Applicant/facility representative was informed of Mandated Reporter Training for self and all assistants. Department web site form was given to down load forms, Title 22 regulations, and trainings on-line at www.ccld.ca.gov. The applicant/facility representative was also informed to visit the website for Quarterly Updates. The applicant was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. or at www.ccld.ca.gov

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The applicant/facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness

The facility was in compliance with Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center does not have enough activity space to support the requested capacity of 40 (School age children).
A Provisional license for 30 school age children will be issued after a final review. The applicant will be notified if any additional information is required.

Applicant was also advised, once licensed, the Notice of Site Visit must be posted for 30 days and if A violations are cited then the Licensing Report (LIC809 or 9099) must be posted by the Notice of Site Visit for a period of 30 days or $100 civil penalties will be assessed, and the report shall posted and copies provided to the parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

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: SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC	FACILITY NUMBER: 304371469
	VISIT DATE: 10/30/2020

NARRATIVE

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Facility is in process of completing the water testing requirement, upon completion within the next 30 days, a report shall be submitted.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The applicant was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

LIC809 (FAS) - (06/04)

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