434404336-10-24-2023-07-CC-JSEA-CZK2N2-20240116163156

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434404336
Report Date: 10/24/2023
Date Signed: 10/24/2023 11:27:57 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2023 and conducted by Evaluator Cortney Nelson

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20231016104408

FACILITY NAME:	STRATFORD SCHOOL		FACILITY NUMBER:	434404336
ADMINISTRATOR:	MEGAN EITZEN		FACILITY TYPE:	850
ADDRESS:	1196 LIME DRIVE		TELEPHONE:	(408) 732-4424
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	312	CENSUS: 126	DATE:	10/24/2023
		UNANNOUNCED	TIME BEGAN:	08:47 AM
MET WITH:	Ramyaa Venkatesh & Megan Eitzen		TIME COMPLETED:	11:37 AM

ALLEGATION(S):

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Staff did not adequately supervise day care children.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Director, Megan Eitzen, and Head of School, Ramyaa Venkatesh, to open 10-day complaint investigation. Upon arrival, LPA was admitted into the school by office personnel and the Site Director, Megan.

During todays inspection, LPA toured inside and outside of the facility, conducted interviews with the Site Director/Head of School and staff, as well as obtained documents such as facility roster and personnel report.

LPA interviewed staff and the Site Director who all confirmed that no one witnessed a child sustain injuries while playing outside, despite evident bleeding from the injury on the child's shirt and face. The child was injured in the evening and did not received first-aid from staff prior to the parent arriving. No injury log was completed for the child's injury. Based on the available evidence, the preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

California Code of Regulations (Title 22, Division 12) are being cited on attached LIC9099-D.

***Report continues on LIC9099-C***

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

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 07-CC-20231016104408

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: STRATFORD SCHOOL	FACILITY NUMBER: 434404336
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/24/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/25/2023 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	101229 Responsbility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The facility has conducted staff meeting to review outside safety requirements and zones of supervision. The Site Director has indicated that staff will be responsible for specific areas while children play outside.
	8 9 10 11 12 13 14	The staff at the facility did not observe a child who sustained injuries while outside , which poses an immediate risk to the health, safety, and personal rights of children in care.	8 9 10 11 12 13 14	Playground rules was reviewed with staff to highlight specific safety concerns for each area of play outside. POC has been cleared.
	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: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

LIC9099 (FAS) - (06/04)

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Control Number 07-CC-20231016104408

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: STRATFORD SCHOOL	FACILITY NUMBER: 434404336
	VISIT DATE: 10/24/2023

NARRATIVE

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** Continued from LIC9099**

LPA informed Site Director, Megan Eitzen, and Head of School, Ramyaa Venkatesh, that this report dated 10/24/2023 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, LPA informed the Licensee to provide a copy of this licensing report dated (10/24/2023) that documents one 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 Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

As a result of today's inspection, a deficiency has been cited, see LIC9099-D.

Exit interview conducted and report was reviewed with the Site Director, Megan Eitzen, and Head of School, Ramyaa Venkatesh.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

LIC9099 (FAS) - (06/04)

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