393617338-1-15-2020-53-CC-SWIS-BKUUSR-20200115145047

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393617338
Report Date: 01/15/2020
Date Signed: 01/15/2020 02:50:52 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:	MY CURIOUS MONKEY'S CHILDCARE		FACILITY NUMBER:	393617338
ADMINISTRATOR:	SOUZA, SHANNON		FACILITY TYPE:	850
ADDRESS:	125 BERVERDOR AVENUE		TELEPHONE:	(209) 832-5437
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	35	CENSUS: 14	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:48 PM
MET WITH:	Shannon Souza		TIME COMPLETED:	03:00 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 Analyst (LPA) Stacey Williams met with Shannon Souza, Director for the purpose of an unannounced annual random inspection. LPA observed (14) fourteen children supervised by 2 staff. Criminal record clearances were verified.

Program hours are Monday through Friday 6AM-6PM. The program operates full day and half day programs. The Half day preschool program hours are 8:30AM-12:00 PM. Program provides morning and afternoon snack. LPA viewed the facility menu posted on a bulletin board in the entry of the center. LPA viewed the kitchen area of the center. Food preparation area is clean, and food was covered and protected from contamination.

LPA toured the facility inside and out. Capacity and ratio requirements were met. All cleaning supplies and hazardous items are stored in cabinets inaccessible to children. Outdoor activity space and equipment was in good repair. Gravel is being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Drinking water was readily available.

Restrooms were sanitary and in operating condition. Storage containers for solid waste had lids. Fire drills are conducted and documented. Carbon Monoxide and smoke detectors were present and operable.

LPA reviewed a random sample of children files during the inspection. LPA observed files included information pertaining to authorized representative, consent for medical treatment and a medical assessment form.

LPA reviewed a random sample of staff records. CPR/First Aid certification was verified for staff (expiration date: February 2021). Immunization records, mandated reporter training completion certificate and documentation of educational background, training, and/or experience was verified in staff files.

Report Continues on 809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MY CURIOUS MONKEY'S CHILDCARE	FACILITY NUMBER: 393617338
	VISIT DATE: 01/15/2020

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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.

There were no Title 22 deficiencies observed during today’s inspection.

This facility evaluation report was reviewed and discussed with Director, Shannon Souza. The implementation of AB 2370, lead exposure was discussed, and PIN 20-01-CCP was provided to the Director.

Director was encouraged to the visit the department’s website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers. Director was provided a copy of the department’s quarterly update report.

Exit interview conducted. A notice of site visit was provided and should remain posted for a period of 30 days for parental review. Appeal Rights provided.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2