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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701115
Report Date: 10/11/2022
Date Signed: 11/02/2022 11:20:00 AM

Document Has Been Signed on 11/02/2022 11:20 AM - 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:PINK TOWER MONTESSORIFACILITY NUMBER:
376701115
ADMINISTRATOR:CHANDANI JAYASINGHEFACILITY TYPE:
850
ADDRESS:203 LAURINE LANETELEPHONE:
(760) 728-4754
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 15DATE:
10/11/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Chandani Jayasinghe-OwnerTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Andrea Taylor and Licensing Program Manager (LPM) Pauline Beschorner were conducting an inspection of the facility when they observed the one staff was inside the building and the other staff walked into the building leaving the preschool children and one infant child on the playground without supervision for less than a minute.

LPA and LPM observed a child under the age of 2 years old on the playground with the preschool children.

LPA and LPM observed children's cots with the bedding on the cots stacked on top of each other with the bedding touching other cots.

LPA and LPM observed mouse droppings in the files which were reviewed during inspection.

These are violation of Title 22 Regulations.

Deficiencies are being cited on 809-D.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Andrea Taylor
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 11/02/2022 11:20 AM - It Cannot Be Edited


Created By: Andrea Taylor On 10/11/2022 at 10:23 AM
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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/11/2022
Section Cited
CCR
101229(a)(1)

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Supervision-Responsibility for Providing Care and Supervision
No child(ren) shall be left without the supervision of a teacher at any time, ... Supervision shall include visual observation.
This requirement was not met as evidenced by:
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The owner stated they will change the schedule
of the staff and submit a new LIC500.
The sign in and sign out sheets outside along with anything else they may use outside so they do not go inside.
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LPA AND LPM observed staff go inside the front door and no staff on the playground with the children. Staff came back outside in less than one minutes time.
This poses a potential risk to the Health and
Safety of children in care.
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Type B
10/11/2022
Section Cited
CCR101161(a)

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Limitations on Capacity
A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement was not met as evidenced by:
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The owner will discuss with child's parent not allowed to have the infant child in the same area ss the preschool children.
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LPA and LPM observed a child under two years of age on the playground with the preschool children.
This poses a potential risk to the Health and
Safety of children in care.
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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:Pauline Beschorner
LICENSING EVALUATOR NAME:Andrea Taylor
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/02/2022 11:20 AM - It Cannot Be Edited


Created By: Andrea Taylor On 10/11/2022 at 10:51 AM
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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: PINK TOWER MONTESSORI
FACILITY NUMBER: 376701115

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2022
Section Cited
CCR
101238(a)(1)

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Buildings and Grounds -The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
The licensee shall take measures to keep the center free of flies, other insects, and rodents.This requirement was not met as evidenced by:
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The owner showed LPA and LPM invoice for pest control.
She will clean out the files and see if there are any new droppings. The service is coming every 3 months
Owner will submit all invoices for the year to LPA.
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LPA and LPM observed mouse droppings in the files which were reviewed during this inspection.
This poses a potential risk to the Health and
Safety of children in care.
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Type B
10/11/2022
Section Cited
CCR101239.1(c)(2)

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Napping Equirpment-Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding. Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.
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The owner will have the staff remove the bedding from the cotts and put in the children's cubbies where they do not touch the other bedding.
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This requirement was not met as evidenced by:
LPA and LPM observed children's napping
cotts with sheets on them stacked on top of each other allowing the bedding to touch
This poses a potential risk to the Health and
Safety of children in care.
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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:Pauline Beschorner
LICENSING EVALUATOR NAME:Andrea Taylor
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2022


LIC809 (FAS) - (06/04)
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