434407977-1-8-2020-07-CC-AALZ-BKMQ37-20200108104815

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434407977
Report Date: 01/08/2020
Date Signed: 01/08/2020 10:48:31 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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:	434407977
ADMINISTRATOR:	ANGELA MANOSCA		FACILITY TYPE:	850
ADDRESS:	6670 SAN ANSELMO WAY		TELEPHONE:	(408) 363-2130
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95119
CAPACITY:	192	CENSUS:	DATE:	01/08/2020
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Manosca, Angela		TIME COMPLETED:	10:55 AM

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	Licensing Program Analyst (LPA) Almaraz, Araceli and Licensing Program Manager (LPM) Segura, Mary met with Director Manosca, Angela, Scwartz, Maggie head of school and Graves, Barbara, Director of licensing and safety. The purpose of this informal office meeting is to discuss violations that took place on 10/25/2019 and 10/29/2019; this meeting was prompted by a case management inspection initiated by a self reported unusual incident that was reported on 10/28/2019 and the written report was faxed to our office on 11/05/2019. On 10/25/2019 a child was left unsupervised and found in the lavatory in classroom 6. Additionally, there was a Type B citation issued on 10/29/2019 in accordance with regulation 101629.1 (b) Sign in and out: (b) The licensee shall require that each child be signed in and out by his/her authorized representative". This requirement was not met as evidenced by child 1-2, not signed in room 6, child 3-4 not signed in room 10. LPA observed during visit a failure to meet this requirement, the count of children was 2 more than signed in in two classrooms. A total of 4 children not signed in at the facility. The following issues were discussed during today's meeting: Based on self report and interviews with staff a Type A deficiency 101229(a)(1) was cited for supervision violation and a civil penalty in the amount of $500.00 was assessed on 11/19/2019. There was an additional Type B violation 101212(d) for failing to submit a written report of the incident within 7 days. The deficiencies were cited in accordance with California Code of Regulations Title 22. The facility has since done the following to correct the deficiencies: Training on supervision provided to all staff on 10/30/2019. Director Manosca submitted proof of staff attendance for this training on 11/20/2019. The Director stated additional training with staff will be ongoing to ensure supervision of children. Director Manosca agreed to convey the severity of lack of supervision to all staff. The Director agreed to review the licensing reports from 10/29/2019 and 11/19/2019 with the staff, and had all staff, including Director sign a statement that this regulation is understood. The Director completed write up reports on staff that failed to provide required supervision. The Director submitted a written statement that staff were written up for lack of supervision on 11/20/2019.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 434407977
	VISIT DATE: 01/08/2020

NARRATIVE

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The Director will continue to do the following in order to ensure all children are accounted for and the facility is in compliance with licensing regulations:

1. Monitor sign in and sign out logs to ensure accuracy.

2. Reassess and revaluate procedures for supervision as needed. All staff required to do a head count each morning, when transitioning to and from class room and at the end of the day. Supervision will be addressed and procedures reviewed at each staff meeting for as long as needed. Staff shall ensure children are supervised at all times.

3. Director will review regulations section 101212 and shall ensure all incidents that merit an unusual incident report are reported to the department both by telephone and in writing by the required time frames.

4. Director shall ensure that all facility staff meet any and all staffing requirements per the regulations and documentation of such shall be maintained in their files and be made available for review by department staff.

The facility will be monitored more frequently to ensure that facility is in compliance with the regulations. LPM advised licensees that the department takes these types of citations very seriously. Also advised if there are continuous deficiencies cited including but not limited to the above issues, this license will be referred to our Legal Department for possible administrative action against the license, which could include revocation.

LPM Segura discussed the requirements of AB633 to Director and provided Director the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and Director understands the requirements. Upon receipt, Director shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

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