<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393622572
Report Date: 03/27/2023
Date Signed: 03/27/2023 12:34:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/19/2023 and conducted by Evaluator Tiffanie Diep
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20230119124238
FACILITY NAME:LITTLE STRIVERS ACADEMY INC.FACILITY NUMBER:
393622572
ADMINISTRATOR:RFACILITY TYPE:
830
ADDRESS:340 MISSION RIDGE DRIVETELEPHONE:
(408) 449-7116
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY:18CENSUS: 7DATE:
03/27/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Azra ArshadTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
License - Facility staff co-mingled day care children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 03/27/2023 at 10:00 AM, Licensing Program Analysts (LPAs) Tiffanie Diep and Lauren Scott met with Director, Azra Arshad, for the purpose of an unannounced complaint visit to deliver the findings regarding the above allegation. There were two staff present supervising seven children.

During the course of the investigation, LPAs conducted interviews with the reporting party, Licensee, and staff and obtained information pertaining to the allegation. It was alleged that facility staff co-mingled day care children. Interviews conducted revealed that children from all programs, including infants, toddlers, and preschoolers, commingle beyond the approved times specified in the facility’s waiver.

Continues on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 53-CC-20230119124238
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: LITTLE STRIVERS ACADEMY INC.
FACILITY NUMBER: 393622572
VISIT DATE: 03/27/2023
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
Based on the information obtained during interviews, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12, Chapter 1), are being cited on the attached LIC 9099-D.

LPAs Tiffanie Diep and Lauren Scott informed the director, Azra Arshad, that this report dated 03/27/2023 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs Tiffanie Diep and Lauren Scott informed Director to provide a copy of this licensing report dated 03/27/2023 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgment of Receipt of Licensing Reports (LIC 9224), or other written statement, must be placed in the child’s file for verification.

An exit interview was conducted and report was reviewed with the director, Azra Arshad. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 53-CC-20230119124238
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: LITTLE STRIVERS ACADEMY INC.
FACILITY NUMBER: 393622572
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/28/2023
Section Cited
CCR
101161(a)
1
2
3
4
5
6
7
101161 Limitations on Capacity (a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license…

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Facility waiver is terminated effective immediately. Director stated they will ensure day care children from all programs are not commingled at any time going forward. Director will relocate sign-in/out sheets to the facility’s main entrance for all programs and submit photos to LPA.
8
9
10
11
12
13
14
Based on interviews, the licensee did not ensure compliance with the specified conditions and limitations as children from all programs commingle beyond the approved times of the facility’s waiver which poses an immediate health, safety, or personal rights risk to children in care
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/19/2023 and conducted by Evaluator Tiffanie Diep
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20230119124238

FACILITY NAME:LITTLE STRIVERS ACADEMY INC.FACILITY NUMBER:
393622572
ADMINISTRATOR:RFACILITY TYPE:
830
ADDRESS:340 MISSION RIDGE DRIVETELEPHONE:
(408) 449-7116
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY:18CENSUS: 7DATE:
03/27/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Azra ArshadTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Admission Agreement - Facility staff did not follow infant's feeding plan
Admission Agreement - Facility staff gave infants pacifiers that are not specific to the infant it is being given to
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 03/27/2023 at 10:00 AM, Licensing Program Analysts (LPAs) Tiffanie Diep and Lauren Scott met with Director, Azra Arshad, for the purpose of an unannounced complaint visit to deliver the findings regarding the above allegation. There were two staff present supervising seven children.

It was alleged that facility staff did not follow infant's feeding plan. It was also alleged that facility staff gave infants pacifiers that are not specific to the infant it is being given to. During the course of the investigation, LPAs conducted interviews with the reporting party, Licensee, staff, and multiple parents and obtained relevant documents. Information obtained revealed that staff develop a needs and services plan for children, including feeding and sleeping/napping, with parents/guardians and regularly communicate with parents/guardians regarding any changes to the plan. Interviews conducted did not disclose sufficient information that was evident to support the allegations that facility staff did not follow infant's feeding plan and gave infants pacifiers that are not specific to the infant it is being given to.
Continues on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20230119124238
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: LITTLE STRIVERS ACADEMY INC.
FACILITY NUMBER: 393622572
VISIT DATE: 03/27/2023
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
Based on the information obtained during interviews and records reviewed, it is determined that the allegations could not be substantiated or dismissed. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted and report was reviewed with the director, Azra Arshad. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5