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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408056
Report Date: 11/07/2019
Date Signed: 11/07/2019 01:26:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:STRATFORD SCHOOLFACILITY NUMBER:
434408056
ADMINISTRATOR:SMRITI DATTAFACILITY TYPE:
850
ADDRESS:870 NORTH CALIFORNIA AVENUETELEPHONE:
(650) 493-1151
CITY:PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:216CENSUS: 116DATE:
11/07/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Smriti DattaTIME COMPLETED:
01:40 PM
NARRATIVE
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LPA Dayna Collier met with Director of Early Childhood Education Smriti Datta for a case management inspection as a result of receiving two unusual incident reports. An incident occurred when staff transitioned a group of children from one classroom to another classroom. When staff entered the new classroom, a head count was conducted which confirmed that one child was missing. One staff member walked back to the classroom that was previously exited and a parent was coming out of the room with the missing child. The child had left the line to use the bathroom. Per staff, the child was unsupervised for a minute or less. Following the incident, transition protocols were reviewed with staff.

The attached type A deficiency is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parent/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

An exit interview was conducted and the report was discussed. Licensee was provided a copy of their appeal rights (LIC 9058 12/15) and the signature on this form acknowledges receipt of these rights.

A site visit notice was posted by the Director.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: STRATFORD SCHOOL
FACILITY NUMBER: 434408056
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/14/2019
Section Cited

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101229 Responsibility for Providing Care and Supervision
a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) 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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This requirement was not met as evidenced by report review and interviews. This poses an immediate risk to the health and safety of children in care.
A CHILD WAS LEFT ALONE IN THE CLASSROOM DURING A TRANSITION.
AN LIC 421IM FORM WAS GIVEN.
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ANY SUBSEQUENT VIOLATIONS OF LACK OF SUPERVISION WITHIN A 12 MONTH PERIOD MAY RESULT IN A $1000 CIVIL PENALTY,

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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: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:
DATE: 11/07/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/07/2019
LIC809 (FAS) - (06/04)
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