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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393600441
Report Date: 09/10/2021
Date Signed: 09/10/2021 01:49:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MONTESSORI SCHOOL OF TRACYFACILITY NUMBER:
393600441
ADMINISTRATOR:TERESA MORENOFACILITY TYPE:
850
ADDRESS:100 SOUTH TRACY BOULEVARDTELEPHONE:
(209) 833-3458
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY:240CENSUS: 120DATE:
09/10/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Teresa MorenoTIME COMPLETED:
02:10 PM
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On September 10, 2021 Licensing Program Analysts (LPAs) Stacey Williams and Elvira Sierra arrived at the above facility for the purpose of conducting a case management inspection . LPAs met with Facility Representative. LPAs observed 110 children supervised by 12 staff. Criminal record clearances were verified for staff.

LPAs discussed COVID-19 guidelines for Child Care Providers. Facility Representative explained the facility protocol concerning COVID-19. LPAs observed children wearing masks during the inspection. Adequate spacing was observed for children that were napping.

Facility Representative was encouraged to review the department website for continued guidance concerning COVID-19 for Childcare Providers.

No Deficiencies observed during today's inspection.

Notice of Site provided and exit interview was conducted with the Facility Representative, Teresa Moreno.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
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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