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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843218
Report Date: 05/30/2019
Date Signed: 05/30/2019 10:58:33 AM

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:SUNNYMEAD MONTESSORI SCHOOLFACILITY NUMBER:
334843218
ADMINISTRATOR:TILLEKERATNE, DELRINEFACILITY TYPE:
840
ADDRESS:24851 BAY AVENUETELEPHONE:
(951) 924-1425
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:14CENSUS: 13DATE:
05/30/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Delrine TillekeratneTIME COMPLETED:
11:02 AM
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Licensing Program Analyst (LPA) Kim Leung returned to the facility conducting a follow up inspection. During previous inspection on 5/17/2019, licensee/director Delrine Tillekeratne agreed to place additional cushioning material to absorb falls on the playground. During this inspection, LPA observed additional cushioning material (combination of sand and pea gravels) in the fall zones of the swing sets, climber and the slides. The Notice of Site Visit issued on 5/17/2019 was posted up at the wall as required. Certificate of completion of Mandated Reporter Training were received from licensee/director Delrine Tillekeratne prior to this inspection.

No deficiency was cited during this inspection. Exit interview was conducted with Ms. Tillekeratne and Notice of Site Visit was issued and it must be posted for 30 days from this date. A copy of this report was provided to the facility.

This report must be made available at the facility for 3 years for public review upon request.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
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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