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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010324
Report Date: 12/19/2022
Date Signed: 12/19/2022 10:56:00 AM

Document Has Been Signed on 12/19/2022 10:56 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LITTLE FLOWERS MONTESSORIFACILITY NUMBER:
483010324
ADMINISTRATOR:RUWANGI D. SUMANASEKERAFACILITY TYPE:
850
ADDRESS:2500 NORTH TEXAS STREETTELEPHONE:
(707) 665-5530
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 190TOTAL ENROLLED CHILDREN: 190CENSUS: DATE:
12/19/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Rajitha SumanasekeraTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with the applicant to conduct a prelicensing inspection. The application was received on November 18, 2022. The fire inspection request was sent to the Fairfield Fire Department. The fire clearance has not been received to date.

The facility has seven classrooms. Each classroom has toilets and sinks within the classroom. The application is requesting approval for 190 preschool age children. There is sufficient square footage, toilets and sinks to support the application capacity. There is sufficient equipment, furniture, toys and cots for the number of children. The center will provide lunch and snacks for the children in care. Upon licensure the facility will meet the requirement for water lead testing if required.

The outdoor activity area has turf and cement areas for the children which is completely fenced. There are age appropriate equipment for the children. There is sufficient shade for the children. The square footage for the outdoor activity area is large enough for 61 children. The facility will utilize an outdoor rotational waiver for no more than 60 children at an given time. The waiver request and rotation schedule has been given to LPA Ouye to submit for approval.

The applicant was reminded that all adults 18 years 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.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: LITTLE FLOWERS MONTESSORI
FACILITY NUMBER: 483010324
VISIT DATE: 12/19/2022
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The LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted was provided to the applicant.

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.

Upon receipt of the approved fire inspection from the Fairfield Fire Department, the facility will be approved for licensure.

Exit interview conducted and report was reviewed with the applicant, Rajitha Sumanasekera
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC809 (FAS) - (06/04)
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