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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393617338
Report Date: 06/20/2022
Date Signed: 06/20/2022 10:48:02 AM


Document Has Been Signed on 06/20/2022 10:48 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:MY CURIOUS MONKEY'S CHILDCAREFACILITY NUMBER:
393617338
ADMINISTRATOR:SOUZA, SHANNONFACILITY TYPE:
850
ADDRESS:125 BERVERDOR AVENUETELEPHONE:
(209) 832-5437
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY:35CENSUS: 7DATE:
06/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Shannon SouzaTIME COMPLETED:
10:30 AM
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Application Specialist (AS) Alecia Sifuentes met with Licensee, Shannon Souza for the purpose of an announced case management inspection. Licensee requests to serve 6 toddlers age 18-36 months under the Toddler Option Program. The facility is currently licensed for 35 children which includes a school-age option of 12 school-age children. Licensee will be providing care and supervision for 6 toddlers, 17 preschool children, and 12 school-age children. The program operates Monday through Friday from 6:00 a.m. to 6:00 p.m. The fire clearance was granted and received on 6/10/2022. The facility provides breakfast, morning snacks, and afternoon snacks.

INDOOR ACTIVITY SPACE:
There is one toddler classroom, two preschool classrooms, and one school-age classroom (located in the church). The total classroom space contains a total of 1,238 square feet, which will accommodate Licensee's request for 6 toddler children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). There are 2 toilets and 2 sinks for the toddler and preschool children and a separate restroom for the school-age children which includes 2 toilets and 2 sinks (located in the church). There is a separate private restroom for the staff.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property. AS used current outdoor measurements. The outdoor play area contains a total of 4,590 square feet which will accommodate Licensee's request for 6 toddler children. Licensee has requested a Shared Outdoor Space Wavier. Licensee states that the toddler children will not commingle with the preschool and school-age children. Licensee provided AS with outdoor daily schedules.

Report continues on LIC809-C.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:
DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/20/2022
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: MY CURIOUS MONKEY'S CHILDCARE
FACILITY NUMBER: 393617338
VISIT DATE: 06/20/2022
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Licensee 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.

AS discussed the safe sleep regulations with Licensee 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. AS also informed Licensee 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.

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.

Exit interview conducted and report was reviewed with the Licensee, Shannon Souza. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Effective today, 6/20/2022, AS will approve the capacity change licensed to serve children from age 2 years to entry into kindergarten, 6 toddlers age 18-36 months under the Toddler Option Program, and 12 children enrolled in kindergarten and above under the School-age Option Program
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
LIC809 (FAS) - (06/04)
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