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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018949
Report Date: 02/04/2020
Date Signed: 02/04/2020 11:20:05 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:STRATFORD SCHOOL- ALTADENA ALLENFACILITY NUMBER:
198018949
ADMINISTRATOR:VASQUEZ, LISAFACILITY TYPE:
850
ADDRESS:2046 ALLEN AVE.TELEPHONE:
(626) 794-1000
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:150CENSUS: 61DATE:
02/04/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Lisa VasquezTIME COMPLETED:
11:25 AM
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Licensing Program Analysts (LPAs) Crystal Green and Thelma Razo conducted an unannounced case management inspection to follow up on an incident that was reported to the Department on 01/08/2020. LPAs met with Judy Burbank, Head of School and Lisa Vasquez, Director. Census was taken.

On 01/08/2020, an incident was reported to the department where during AM recess time, child #1 was running on the grassy area of the playground and tripped which resulted in an open wound located on child #1 head. The facility reported this incident to the Department within the required 24 hours period. During this inspection, Licensing staff observed the outdoor play area where the incident occurred, obtained and reviewed medical documents, and conducted (2) staff interview. Per Director, child #1 received medical attention immediately by the staff members present and child #1 did not required medical stitches and was able to return to school the next day. Based on licensing staff observation of the outdoor play area and staff interviews conducted, LPA determined there was adequate supervision provided the day of the incident. Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit.

Exit interview conducted with the Director, Lisa Vasquez.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
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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