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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371468
Report Date: 01/26/2024
Date Signed: 01/26/2024 03:39:15 PM

Document Has Been Signed on 01/26/2024 03:39 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING ACFACILITY NUMBER:
304371468
ADMINISTRATOR:LUCERO RUBIFACILITY TYPE:
830
ADDRESS:1845 WEST LA PALMATELEPHONE:
(714) 215-4293
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 9DATE:
01/26/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director, Angelica Burgos TIME COMPLETED:
04:00 PM
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On 1/26/24 Licensing Program Analyst (LPA) Nunez conducted an unannounced Case Management visit to ensure that the facility is staying within compliance of Title 22 regulations.

LPA met with Director Angelica Burgos. LPA took census in the infant and toddler option classrooms. There were 3 infants with 1 staff member in room number 2 and 6 toddlers (option program) in room number 3 with 1 staff member. The facility was operating within its licensed capacity and within compliance of staff-to-child ratios. An on-site Facility Personnel Report Summary review showed that all facility residents, staff, or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions.



During the inspection in room 2, LPA observed 1 infant asleep in the crib with nothing inside the crib. LPA observed 2 infants awake in the crib on top of a U-shaped pillow with a blanket and bottles inside the cribs. In room 3, LPA observed 6 toddlers napping on cots with a staff member inside. LPA also reviewed 3 staff files and 3 children’s files. LPA observed and reviewed the LIC 9227 in the children’s files and the sleeping logs and were in compliance.

Based on LPAs observations the following violation was observed is being cited in accordance with California Code of Regulations, Title 22, H&S 1596.8595(c), is being cited on the attached LIC 809D.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC
FACILITY NUMBER: 304371468
VISIT DATE: 01/26/2024
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The LPA conducted an exit interview and reviewed the report with director Angelica Burdogos. The “Notice of Site Visit” was posted, and the licensee is aware that it shall remain posted for 30 days. The Appeal Rights were explained. The licensee received a copy of the Appeal Rights (LIC 9058 01/16), their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First-level appeals should be sent to the Regional Manager to the address listed above.

End of Report

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/26/2024 03:39 PM - It Cannot Be Edited


Created By: Aiddee Nunez On 01/26/2024 at 03:02 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SERENDIB ANAHEIM LLC, DBA LITTLE MINDS LEARNING AC
FACILITY NUMBER: 304371468

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/02/2024
Section Cited
CCR
101439.1

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101439.1 Infant Care Center Sleeping Equipment (f) Cribs shall be free from all loose articles and objects, including blankets and pillows. Thid requirement was not met as evidenced by:
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Director stated she will not have no objects inside the cribs and will write a statement and will send it to the LPA via email.
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LPA observed 2 awake infants inside the crib on top of a U-shaped pillow with blankets and bottles inside the crib.
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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:Thuy Ho
LICENSING EVALUATOR NAME:Aiddee Nunez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2024


LIC809 (FAS) - (06/04)
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