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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434406722
Report Date: 04/25/2024
Date Signed: 04/25/2024 10:08:15 AM


Document Has Been Signed on 04/25/2024 10:08 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:STRATFORD SCHOOLFACILITY NUMBER:
434406722
ADMINISTRATOR:SRUTHI SUNDERFACILITY TYPE:
850
ADDRESS:820 WEST MCKINLEY AVENUETELEPHONE:
(408) 737-1500
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:288CENSUS: 82DATE:
04/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Sruthi SunderTIME COMPLETED:
10:30 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Mel Matos and Mandeep Kaur met with Shruthi Sunder, director, for an unannounced case management investigation. Purpose of today's investigation: discuss an incident report that the Facility self reported to the Department on April 22, 2024.

Shruthi states that the incident occurred on Friday April 19, 2024 during the afternoon transition from classroom to playground. Shruthi states that Classroom 5 had 21 children with two teachers and did a name to face count 1) inside the classroom, 2) outside the classroom, and 3) right before entering the playground area (located approximately 20 feet from the classroom). Shruthi states that one preschool teacher was stationed at the front of the line and the second preschool teacher was stationed at the end of the line during all three face to face counts. Shruthi states that one preschool child went back into the classroom after the second name to face count and staff became aware of it when the third name to face count was completed (approximately 1 minute later). Note: the preschool playground is located approximately 20 feet from Classroom 5.

Shruthi states that staff went to retrieve the child from Classroom 5 after the third name to face count (which was approximately 1 minute after the second name to face count). Shruthi states that the child was fine and was just sitting inside the classroom. Shruthi states that the staff immediately notified her of the incident and Shruthi states that she also notified the child's parents of the incident. Shruthi states that the parents were understanding and states that the child is still enrolled at the Facility.

Shruthi states that she spoke with the two staff from Classroom 5 about the incident and also met with staff on April 22 & 23, 2024 to provide training regarding supervision and transitions. Copies of training materials were provided to LPAs during today's investigation.

LPAs conclude that there was a lapse of supervision during transition time on Friday April 19, 2024. This presents a potential health & safety risk and thus a "Type B" deficiency is cited on the attached page (809-D). Exit interview conducted and report was reviewed with the director, Shruthi Sunder and copy of appeal rights was provided. A Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Belinda DevallTELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 04/25/2024 10:08 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: STRATFORD SCHOOL
FACILITY NUMBER: 434406722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/25/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision: No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Facility Director, Shruthi Sunder, met with staff on April 22 & 23, 2024 to provide training regarding supervision and transitions. Copies of training materials were provided to LPAs during today's investigation.
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This requirement was not met as evidenced by: one preschool child was left unattended for approx 1 min in Classroom 5 during transition time on 04/19/24. This presents a potential risk to the health, safety or personal rights of children in care.
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Facility has completed the required Plan of Correction and today's deficiency is thus cleared.

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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: Belinda DevallTELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2024
LIC809 (FAS) - (06/04)
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