434400049-3-13-2025-52-CC-CCHS-DEUPP7-20250317112904

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434400049
Report Date: 03/13/2025
Date Signed: 03/13/2025 03:00:57 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/10/2025 and conducted by Evaluator Jialing Zhu

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20250310105436

FACILITY NAME:	COUNTRY DAY LITTLE SCHOOL		FACILITY NUMBER:	434400049
ADMINISTRATOR:	PEGGY JANE TRIULZI		FACILITY TYPE:	850
ADDRESS:	3990 VENTURA COURT		TELEPHONE:	(650) 507-5787
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	40	CENSUS: 7	DATE:	03/13/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Amanda "Ananda" Triulzi		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Nature of Complaint: License - Day care is operating out of scope of license

INVESTIGATION FINDINGS:

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On 03/13/2025 at 1:00pm, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu conducted an UNANNOUNCED COMPLAINT SITE INSPECTION. LPA met with Director Ananda Triulzi. LPA advised director of the nature of the inspection. A complaint regarding License was filed against the facility. LPA toured the facility for health and safety inspection. Present during the inspection were three (3) fingerprint-cleared staff and seven (7) children in care.
LPA confirmed with director the Facility Roster and Personnel Report obtained on 01/10/2025 is still current as of today’s inspection. LPA conducted interviews with director and one (1) staff present at the facility. Interviews with director and staff both indicated a staff’s child under the age of two is occasionally present at the facility, which is out of the scope the facility’s license. Based on LPA’s observations and interviews conducted, 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, 101161(a) is being cited on the attached LIC 9099D.
Notice of Site Visit was given and must remain posted for 30 days. Report was reviewed, exit interview was conducted, and Appeal Rights were provided with Director Ananda Triulzi.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Jialing Zhu	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 52-CC-20250310105436

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: COUNTRY DAY LITTLE SCHOOL	FACILITY NUMBER: 434400049
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/13/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/11/2025 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, including the capacity limitation. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director will provide a written statement to address how she will ensure the facility will stay within the scope of the license. The facility is licensed to served children ages 2-6 only.
	8 9 10 11 12 13 14	Based on observation and interview, the licensee did not comply with the section cited above as a staff's child under the age of 2 was occasionally present at the facility, which poses a potential health, safety, and/or personal rights risk to persons in care.	8 9 10 11 12 13 14	The written statement will also include details of staff's alternative childcare option(s). Director will email the written statement to LPA at jialing.zhu@dss.ca.gov by 04/11/2025.
	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.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Jialing Zhu	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025

LIC9099 (FAS) - (06/04)

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