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4921 Supporting Documents
ones child 0ilvan a Pai,m COA Play. Learn and�" 45 ® Grow... Together/ 17 WIICHWCOD RV 508-360-5006 SOUTH Ywmoum 0266' MA OCT 0 6pgRD,q Op Mp frN monday To Friday �:00 AM To 5: oo PM ti N c O � G V .0 E W SC m w 0 O z N W O Z fi p y y U N J E C r �7 a U � J InLU a �, fli � 0 E V) a I ao LO 0 1 ¢v LO o 3 cm O W J c U- � co as O �o a w '> U w W LL z� a ~ � Y W00 p � d O O c w 2 Ca u ° w =a J o a V m �o o r O m 'D I c O g ti o a 3 a I 0 °° 0 N� ? O O a c M o o G N °' I m d d r � o C14 m O a co 00 a M M •c Ci N y 00 L N a +� N O d IT 0.2 E ' ^ �; o ++ r- M Z O O Z O 61 E fn i0 ate+ 0 - a m u U m ci, m O m a (n ti Q} O u 0 w ,O 'i7 .. O O ' �. Q. c c a) � Q1 a` 5 a LL y x � Y.2 �� a X f IRS DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE PHILADELPHIA PA 19255-0023 0 002170 002170.357970.312200.25107 1 MB 0.450 530 1611111111111ig111111di1,11111i'1 GILVANIA MARIA PEREIRA PAIVA LITTLE ONES CHILD CARE 17 WITCHWOOD RD SOUTH YARMOUTH MA 02664 Date of this notice: 07-29-2021 Employer Identification Number: 87-1848085 Form: SS-4 Number of this notice: CP 575 G For assistance you may call us at 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 87-1848083. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above, Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear -off stub and return it to us. A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an association taxable as a corporation. If the LLC is eligible to be treated as a corporation that meets certain tests and it will be electing S corporation status, it must timely file Form 2553, Election by a Small Business Corporation, The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. • Refer to this EIN on your tax -related correspondence and documents. • Provide future officers of your organization with a copy of this notice. Your name control associated with this EIN is PAID. You will need to provide this information, along with your EIN, if you file your returns electronically. If you have questions about your EIN, you can contact us at the phone number or address listed at the top of this notice. If you write, please tear off the stub at the bottom of this notice and include it with your letter. Thank you for your cooperation. Diana Texiera Contracts Manager/Child Care Coordinator Child Development and Education, Inc. 76 West Main Street Hyannis, Ma 02601 Cell: 781.960.4487 Office: 5.08.778.1683 Fax: 508.778.1686 JChild Development and Education Date: 7/15/21 Arrival Time: 11:00 am Departure Time: 12:05 am Provider: Gilvanin Paiva Address: 17 Witchwood Rd City: South Yarmouth Tel: (508) 360-5006 License#: 9053927 Exp. 1130123 CDA: Yes[] No❑x / CDA Exp: CPR/Exp: 9129121 First Aid/Exp: 9/29/21 Evac Date: 7/8/21 Capacity: 6 Certified Assistant: Mariana Castaneda De Menezes P-250443 License#: 9024918 Exp: 7116123 CPR/Exp: 1/25/22 First Aid/Exp: 1/25/22 How many children currently enrolled: Under 2: '- 5chool-Age: 0 Full Time: 6 Part Time: 0 Total Number of Children: `` 1 Julian Benjamin R Yes ❑No 2/23/19 Voucher 7:00 am 5:00 pm Yes ❑No 5117/22 5122/22 Z Julia Nicolette DYes ❑No 6/13/20 Private 7.00am 5:00 pm ❑Yes ❑No Ill/00 111/00 3 Katana Bogle ®Yes ❑No 4121/19 Voucher 8:00am 4:00pm ®Yes ❑No 4/20/22 3/1/22 4 Harrison Foster Mx Yes No 818118 Voucher 9:00 am 4:00 pm ®Yes ❑No 1/21/22 2/8122 5 Zelda Schirmer ©Yes No 6/19119 Private 8:00 am 5:00 pm ®yes ❑No 4124122 1/20/22 5 Elisha Blanc ® Yes ❑ No 12/7/20 Voucher 7.00 am 5,00 pm Q Yes ❑ No 12/10/21 5/23/22 7, ❑YesI]No El Yes ❑No 8. ❑ Yes ❑ No ❑ Yes ❑ No 9. ❑Yes ❑No ❑Yes ❑No 10, ❑Yes ❑No []Yes ❑No Physical Facility/ Conditions: Clean and organized, ample logs and activities Daily Activities Observed / Describe Curriculum and Participation with Provider and Children: Children were free play outside, then came in and danced to music and sang songs to transition to lunch time, Additional Support Requested By Provider: Extra supports requested for Julian Benjamin. He is showing some developmental issues that she would like an opinion about Attendance Sheets and Parent Sign-In/Out Reviewed? R Yes ❑ No Comments Regarding Attendance Records: Up to dale. Mariana signs in when she is wofking with Gilvania at The bottom of the page. Professional Development and Technical Support Comments: Gilvania asked for help with Julian Benjamin as he is showing some behaviors that she thinks are not typical of a child his age. IF transitioning from one activity to another is more difficult for him than that of others his age, he is not talking much and she has seen him react negatively to food textures. He also doesn't engage with the group and prefers to play alone away from children and educators_ 1 have discussed with Gilvania that I will send her an ASQ assessment and she can have herself and the mom fill out and see where his goals and milestones meet up.. We will revisit once she has completed the ASQ_ Gilvania had a small plastic table in front of a front door she no longer uses. I discussed that even though the exit is not currently being used, it still must be tree and clear oran%y obstacles. (She removed the table). We discussed her application to a 10license. She will need to wait until Mariana gets her Large FCC assistant certificate to apply- Gilvania is looking forward to lots of summer time activities and will prepare more curriculum and theme based activities for the fall. COORDINATOR'S SIGNATURE: PROVIDER'S OR ASSISTANT'S SIGNATURE: DATE- 7115121 v DATE; 7/15/21 LAST REVISION 03/17 Original - Provider I Copy - Office/Prov.He 'M Child Development and Education Date- 819/21 Arrival Time: 2:30 pm Departure Time: 3:25 pro Provider: Gilvania Paiva Address- 17 Witchwood Rd City. South Yarmouth Tel: (508) 360-5006 License#: 9053927 Exp. 1/30/23 CD.A: Yes— NoR ? CDA Exp: CPR: Exp: 9/29121 First Aid:'Exp: 9129121 Evac Date: 7/8/21 Capacity: 6 Certified Assistant: Mariana Castaneda De Mcnczes P-250443 License=: 9024918 Exp: 7/16123 CpR/Exp: 1/25122 First Aid/Exp: 1125i22 How many children currently enrolled: Under 2: 2 School -Age: 0 Full Time: 6 Part Time: 0 T-_ai Number of Children: Julian Benjamin 5L. Yes NU 2123/19 Voucher 7:00 am 5:00 pm [t Yes ] No 5117/22 5/220-2 I Julia Nicoletle Yes _ No 6i ] 3/20 Private 7:00 am 5:00 pm 7 Yes No 11l/00 1/l/00 3 Katana Bogle Yes ` No 412l/19 Voucher 8:00 am 4:00 pm Fg Yes ] Nn 4/20/22 3/l/22 a Harrison Foster X vs —No 88118 Voucher 9:00 am 4:00 pm Yes ] No 1121122 218122 5 Zelda Schirmer �x Yes - N0 6/19119 Private 8:00 am 5:00 pm Yes ] No 4124/22 1120122 5 Elisha Blanc iM Yes ^ vo 12/7/20 Voucher 7:00 am 5:00 pm [i yas ] No 12/10/21 5/23122 7. Yes i' No .... Yes Na 8. _ Ye- ` Vo "" Yes ] No 9 _ Yes L vo "" (— Yes ] No 10- u Ye;:: 1c Yes ] No Physical Facility / Conditions: Clean and organized, ample toys and activities Daily Activities Observed 1 Describe Curriculum and Participation with Provider and Children: 4 Children were resting and 2 were already awake at the start of today's visit. Additional Support Requested By Provider: Extra supports requested for Julian Benjamin. Gilvania will complete a targeted progress report checklist and send me the results. Also will give parents a copy of Attendance Sheets and Parent Sign-In/Out Reviewed? W. Yes [I No Comments Regarding Attendance Records: i Completed daily. Professional Development and Technical Support Comments: Today we discussed Julian Benjamin's progress in the program. Gilvania is still concerned with his development and milestones. I gave her 2 check list type progress reports and a CDC pamphlet of the developmental milestones that typical 2 year old children achieve. She is going to complete the checklist and progress I report and send me the information along with giving the copies to Julian's mom. She will talk to mom about where Julian is with respect to the reports and see if she is responsive to Gilvania's concerns. I will send Gilvania a list of early intervention programs in the family's area of Dennis port to aid Gilvania with the conversation. Last week the children worked on painting a picture of an umbrella and finger tip colored raindrops. All the children participated in this project. She has applied for the AR -PA grant with the start month of July. She moved the small children's table away from the front door that was there last time and has an angled toy holder COORDINATOR'S SIGis1ATllRE: DATE: 8/912 l CPRC)VlD5,R'S OR A55157ANT'S SiGINATURE-. DATE: 8/9121 LA57 REVISION ,33. 17 Original - Provider Copy - OfficOProv.Fiie J Child Development and Education Date: 9'28121 Arrival Time: 9 10 am Departure Time: 10:15 am Provider: Gilvania Paiva Address: 17 Witchwood Rd City: South Yarmouth Tel: (508) 360-5006 License#: 9053927 Exp: 1/30/23 CDA: Yes[] No❑x / CDA Exp: CPR/Exp: 9/29122 First Aid/Exp: 9/29/22 Evac Date: 9/7/21 Capacity: 6 Certified Assistant: Mariana Castaneda De Menezes P-250443 License#: 9024918 Exp: VI&23 CPR/Exp: 1125/22 First Aid/Exp: 1125/22 How many chiidren currently enrolled: Under 2: 2 School -Age: 0 Full Time: 6 Part Time: 0 Total Number of Children: I Julian Benjamin Yes ❑ No 2/23/19 Voucher 7:00 am 5:00 pm ®Yes ❑No 5117122 5/22122 2 Julia Nicolette ©Yes []No 6/13/20 Private 7.00 am 5:00 pm ❑Yes ❑No 1/l/00 l/l/00 3 KatanaBogle Eyes []No 4121/19 Voucher 8:00am 4:00pm ®Yes ❑No 4/20/22 311122 4 Harrison Foster {]Yes []No 8/8/18 Voucher 9:00 am 4:00 pm ®Yes ❑No 1/21/22 2/8/22 5 Zelda Schirmer ®Yes ❑No 6/19/19 Private 8-00 am 5:00 pm ®Yes ❑No 4/24122 1/20/22 6 Elisha Blanc ©Yes ❑ No 1217/20 Voucher 7:00 am 5.00 pm Yes ❑No i] 12/10/21 5123/22 7. ❑ Yes [-]No ❑ Yes F 1 No 8. []Yes ❑No ❑Yes ❑No 9. ❑Yes ❑ No ❑ Yes ❑ No 10, ❑ Yes ❑ No ❑ Yes ❑ No Physical Facility/ Conditions; Clean organized with various activities available for children to use on their own Daily Activities observed 1 Describe Curriculum and Participation with Provider and Children: Asst. Mariana was helping the children with their individual activities as they sat at small one person tables (coloring, play dough, farm animals) Additional Support Requested By Provider: She has a hearing scheduled with the Town of Yarmouth for her daycare to be approved as a business in the town - Attendance Sheets and Parent Sign-In/out Reviewed? ❑x Yes ❑ No Comments Regardina Attendance Records: Professional development and Technical Support Comments: Discussed renewal of her CPR & FA. Made corrections to her dates on the iPad. She is valid until next Sept- 2022- We discussed Marianas CPR & FA renewal She will need the CPR renewed in January 2022 if the EEC rules require the yearly CPR at that time. We discussed ages 5 and over plus all adults wearing masks at all times while with the children and/or inside her program. Discussed improvements with Julian's development. I shared with Gilvania that 1 spoke to Julian's mother yesterday and discussed his progress reports and behavior at care_ She loves Gilvania's program and doesn't feel that Julian is behind in any of his learning or development. I told Julian's mother that Gilvania doesn't provide a structured preschool program and that a program such as that ma} be very beneficial to Julian prior to Kindergarten- Gilvania agreed to give it some more time to see how he does and we will revisit in a month. We discussed that she could give a 2 week notice if she feels that her program is not the right fit for him. Daily's schedule posted on wall & many cra s . - tivities posted on daycare room walls, COORDINATOR'S SIGNATURE: u DATIE- 9/28121 PROVIDER'S OR ASSISTANT'S SIGNATURE; �PG.II• ���� DATE: 9129/21 LAST REVI510N 03117 original - Provider I Copy- OHice/Prov.File Letter of Authorization I, Sergio Pinto Paiva, being owner of the house 17 Withwood Rd, South Yarmouth, authorize my wife Gilvania Maria Pereira Paiva to have her DayCare business on our property for the work. I DECLARE THE ABOVE INFORMATION TO BE TRUE. Massachusetts, 01 Octuber 2021 A 9 RWI ob W W i' 'o �e ..I Q uj P sr x'{1,yi `p b3yy J IS" RVC, �h Z Y �9671tlJ d lJ �.r e I a Iff/ -;ram a_r�i cr-i' _�.•< � � - e .2 � +:y --.- VqT 71W' f a :mil.• a. 1� NAS s , t�W y�7B_�r t ,-.1F� # -b�n�i,�;j �,n tr� �'�-;ea �.. 5Th *, • - �i 9 ° x TOWN OF YARMOUTH BUILDING DEPARTMENT 0 1146 Route 28, South Yarmouth, MA, 02664 (508) 398-2231 ext. 1261 Fax: (508) 398-0836 ZONING DETERMINATION FOR BUSINESS CERTIFICATE APPLICATION The purpose of this form is to determine if your business complies with the Town of Yarmouth Zoning Bylaw. The applicant shall complete the top section of this form and file it with the Building Department. Once the Building Department has made a determination, it will be forwarded to the Town Clerk. hat c.• your €aX ideal€if ic:ation Etu►11hc;r andior your ,ocial sc;curity nurnbcr av-,iilablc % hcn Conipletint dic; application 1)10CC, With €11c I c,ssrt 0,:rk. The Building Department will render a determination based on the following factors: (a) The businessluse, activity, (b) The zoning district in which the business is to be located Allowed rises are based on Zoning Bylaw Table 202.5 and (q) previous or new zoning relief from the Zoning Board of Appeals. Date: (2 � 0 oZ 1 a Telephone: �`�{�� ��Q .50o6 Business Address: A-4 u,�Jr�) vn f-4n � irA (_,p lymciVI i /V1, ,9 02, 66 Name of Applicant: G� L og N I A on I U A DBA: ML aq - A q a�j --- — Mailing Address: A -+ ,l IC L W 1 r! _ (�2_66� Description of Business Activity: I)(-W The applicant acknowledges that a determination will be made by the Building Department based on the information provided on this date. Any changes in the business use and/or activity will require additional approval. The applicant agrees to abide by all conditions referred to below. Failure to do so may result in the revocation of the Business Certificate and/or appropriate Zoning L.riforecment, should it be determined that the changes are non -compliant. Applicant's Signature: I �,C� c �C[ f Building Department Determination Approved: Comments and Conditions 11 Disapproved: Comments and Conditions Date:2?L0 g_ j OZ4 Building Official's Signature: Date: THE COMMONWEALTH OF MASSACHUSETTS TOWN OF YARMOUTH BUSINESS CERTIFICATE Date Filed: Expiration Date: Certificate Number: Certificate Type: Certificate Fee: Original Filing Date: In conformity with the provisions of Chapter One Hundred and Ten (110), Section Five (5) of the Massachusetts General Laws, as amended, the undersigned hereby declare that a business is conducted under the title of: Business Title: Business Address: Business Type: Business Owners: Gj1ONiA SS Tax ID#: Signatures: 01A . 0a Owner(s) Address: Al Will r IIAI C� dlASl In accordance with the provisions of Chapter 337 of the Acts of 1985 and Chapter 110, Section 5, of Mass. General Laws, business certificates shall be in effect for four (4) years from the date of issue and shall be renewed each four (4) years thereafter. A statement under oath must be filed with the town clerk upon discontinuing, retiring, or withdrawing from such business or partnership. Copies of such certificates shall be available at the address at which such business is conducted and shall be furnished on request during regular business hours to any person who has purchased goods or services from such business. Violations are subject to a fine of not more than three hundred ($300.00) dollars and no/100 dollars for each month during which such violation occurs. On statement is true. Clerk the above named person(s) personally appeared before me and made and oath the foregoing Notary Public: Commission Expiration Date: