336300577-11-22-2022-10-CC-ANOE-CLETM6-20221122135036

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336300577
Report Date: 11/22/2022
Date Signed: 11/22/2022 01:50:49 PM

Document Has Been Signed on 11/22/2022 01:50 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	BRIGHT MINDS MONTESSORI,INC.		FACILITY NUMBER:	336300577
ADMINISTRATOR:	DE SILVA, CHAMALI		FACILITY TYPE:	830
ADDRESS:	17159 GRAND AVENUE		TELEPHONE:	(951) 378-4103
CITY:	LAKE ELSINORE	STATE: CA	ZIP CODE:	92530
CAPACITY:	4	CENSUS: 0	DATE:	11/22/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:14 AM
MET WITH:	Nam De Silva		TIME COMPLETED:	02:20 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 Analysts (LPAs), Ana Noble and Lorena Valenzuela conducted a pre-licensing inspection this date for a proposed Infant Program. The days and hours of operation will be: Monday-Friday 6:00 am to 6:30 pm. LPAs met with Nam De Silva, Applicant and Chamali De Silva, Director who led a tour of the facility at 9:45 AM. This is a combination center with Preschool and School Age Programs. The facility was toured inside and out, and the following was observed: · Classrooms are NOT adequately equipped with age and size appropriate furniture and equipment. Classroom has not yet been set up. · Water dispenser and disposable cups, supply drinking water in the indoor activity space · Playground is enclosed by a wrought iron fence. · Outdoor activity area is NOT supplied with age and size appropriate equipment. Equipment has not yet been set up. · There are no accessible bodies of water present. If wading pools or similar products are used, they must be emptied immediately after use and stored in an upright position. · An adequate amount of cushioning material rubber padding is in place under play equipment · Adequate shade is provided by easy ups. · Drinking water is provided in the outdoor play area by water dispenser and disposable cups. · Food preparation area is NOT equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies · The office area is located main building near the entrance · Staff room will serve as the isolation area for ill children temporarily until parents arrive · There is a working telephone located in the facility. · Medication will be stored in the main building in a locked cabinet which is inaccessible to children · Storage area for toxins and poisons is locked, located in storage closet outside office/main building.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 295-5832
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.	FACILITY NUMBER: 336300577
	VISIT DATE: 11/22/2022

NARRATIVE

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· Medication administration forms were reviewed
· First Aid kit is was not available during this visit.
· Sign in/Sign out record was reviewed and meets regulation requirements
· Parent Board located entrance of the office with all required forms.
· Carbon Monoxide Detector located in each building and were test and operable.

Measurements were taken and the following was determined:

Infants Indoor Activity Areas-
LPA has determined that there is sufficient space to accommodate 12 children, Building #1 (4 Infants and 8 Toddlers).

School-age Bathroom Fixtures
2_ toilets x 15 = 30 children
2 sinks x 15 = 30 children

Infant Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 12 children.

Limiting factor is request capacity. The Fire Clearance granted on 11/8/2022.
Infant capacity is limited to12 children (4 infants and 8 toddlers).

During the inspection, the following was reviewed with Facility Representative, Nam De Silva:
· Component II Orientation was completed
· The applicant was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The importance of checking for recalled infant (children) devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant (children) devices with the CPSC to be notified of any recalls on their purchased equipment.

· Provider Information Notice (PIN) 22-20-CCP: Resources and Requirements on Lead Testing in Child Care

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 295-5832
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.	FACILITY NUMBER: 336300577
	VISIT DATE: 11/22/2022

NARRATIVE

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· LPA reviewed Incidental Medical Services (IMS). For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department if the facility will provide the services. 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
· The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

A review of staff records on 11/15/2022 indicates that the applicant and/or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions. The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA discussed the safe sleep regulations with facility representative, Nam and Chamali De Silva, Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with Facility representative the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 295-5832
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRIGHT MINDS MONTESSORI,INC.	FACILITY NUMBER: 336300577
	VISIT DATE: 11/22/2022

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following items need to be completed/corrected prior to a license being issued:

1. Clean and sanitize entire facility (all classrooms, including window, bathrooms ) Follow up inspection will be scheduled and conducted once all plan of corrections are completed.
2. Fix hole in wall in Toddler Room #2.
3. Set up classrooms with all equipment including crib area in Room #1.
4. Replaced damaged ceiling tiles.
5. Set up outdoors playground with equipment.
6. Set up outdoor shade structure.
7. Repair cracks in the cushioning material in the outdoor playground.
8. Repair uneven concrete located between infant building and preschool building.

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 12_children/infants?_. As agreed upon by facility representative, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied.

If all corrections are approved and facility licensed, you must have the drinking water outlets used for drinking and cooking tested for lead and post the results within 180 days of licensure.

Exit interview conducted and report was reviewed with Facility representative Nam De Silva.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana Noble	TELEPHONE: (951) 295-5832
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC809 (FAS) - (06/04)

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